Student: ________________________________ Block: _________

Mindanao State University – Iligan Institute of Technology

COLLEGE OF NURSING

PHARMACOLOGICAL MANAGEMENT

DRUG STUDY

Brand Name: Pletal Generic Name: Cilostazol Drug Classification: platelet-aggregation inhibitors (antiplatelet medications)

Dosage, Route & Frequency

Drug-Drug & Drug- Side Effects Adverse Reactions
Drug Action Indications Contraindications
Food Interactions (By System) (By System)
Recommended Prescribed

Inhibits -Drug-drug. To reduce • Contraindicated CNS: dizziness,

The phosphodiesterase Anticoagulants, symptoms of in patients Cardiovascular: atrial headache, vertigo.
recommended , increasing cAMP, antiplatelet agents: intermittent hypersensitive to fibrillation, heart failure, CV: palpitations,
dosage of leading to myocardial infarction, nodal
May increase claudication drug or its peripheral edema,
PLETAL is 100 inhibition of arrhythmia, supraventricular
platelet bleeding risk. Use components. tachycardia. EENT:
mg twice daily Adults: 100 mg tachycardia, ventricular
taken at least half together extrasystoles, ventricular
aggregation. PO b.i.d. Black Box Warning pharyngitis, rhinitis.
an hour before or tachycardia
Therapeutic Effect: cautiously. Contraindicated in
two hours after Adjust-a-dose: GI: abnormal stools,
breakfast and Improves walking patients with HF of Digestive: anorexia,
distance in pts Fluconazole, Decrease dose any severity. diarrhea, abdominal
dinner. melena
with omeprazole, to 50 mg PO pain, dyspepsia,
Patients may ticlopidine: May b.i.d. when • Contraindicated Hematologic and flatulence,
intermittent
respond as early increase cilostazol giving with drugs in patients with Lymphatic: anemia
claudication. nausea.
as 2 to 4 weeks level. that may interact hemostatic
after the initiation to disorders or active Metabolic and Nutritional:
-Reduce cilostazol Hematologic:
of therapy, but bleeding, such as increased creatinine,
treatment for up dosage to cause an bleeding.
bleeding hyperuricemia
to 12 weeks may increase in Musculoskeletal:
be needed before Pharmacokinetics 50 mg b.i.d. back pain, myalgia.
cilostazol level peptic ulcer and Nervous: insomnia
a beneficial effect Respiratory:
Absorption: (such as intracranial
is experienced. If Erythromycin, other
Moderately fluconazole, bleeding. Respiratory: epistaxis
symptoms are macrolides, strong increased cough.
absorbed from the omeprazole,
unimproved after or moderate Other: infection.
GI tract. ticlopidine, • Use cautiously in Skin and Appendages:
3 months, CYP3A4 inhibitors
discontinue patients with
 Distribution: (diltiazem, diltiazem, severe underlying
PLETAL. unknown. itraconazole, heart disease; also urticaria
Protein binding: erythromycin, use cautiously with
95%–98%. ketoconazole): May itraconazole, Special Senses:
other
Metabolism: increase level of ketoconazole). conjunctivitis, retinal
cilostazol and its drugs having hemorrhage, tinnitus
Metabolized in
metabolites. antiplatelet activity.
liver. Urogenital: urinary
Half life: 11–13 hrs. -Reduce cilostazol • Use cautiously in frequency
dosage to patients with
Excretion: Excreted severe renal Frequent (34%–10%):
in urine (74%), 50 mg b.i.d. Headache, diarrhea,
impairment (CrCl
feces (20%). Not palpitations, dizziness,
removed by <25 mL/minute)
-Drug-herb. Herbs pharyngitis.
hemodialysis. and in those
with anticoagulant
Lifespan properties (anise, Occasional (7%–3%):
considerations with moderate to
bilberry): May severe hepatic Nausea, rhinitis, back pain,
Pregnancy/ prolong bleeding impairment. peripheral edema,
Lactation: time. dyspepsia,
Unknown if drug • Left ventricular
crosses placenta or Discourage use outflow tract abdominal pain,
is distributed in together. tachycardia, cough,
obstruction has
been reported in flatulence, myalgia. Rare
breast milk. -Drug-lifestyle.
Children: Safety patients with (2%–1%): Leg
Smoking: May
and efficacy not sigmoid-shaped
decrease drug cramps, paresthesia, rash,
established.
Elderly: No age exposure. interventricular vomiting.
related precautions Discourage septum.
noted. smoking.
PREGNANCY-
-Drug-Food: LACTATION-
Grapefruit juice REPRODUCTION
inhibits metabolism
• There are no
and effects; adequate studies in
concurrent use pregnant women.
should be avoided. Therefore,
assessment of risk
 to the fetus

isn't possible.

• Drugs may
appear in human
milk. Patient should
discontinue
breastfeeding or
discontinue drug,

taking into account

the importance of
drug to the mother.

Responsibilities in the Nursing Process (ADPIE) Responsibilities in the Nursing Process (ADPIE)

Assessment Patient Teaching

● Assess patient for intermittent claudication before • Instruct patient to take drug on an empty stomach, at least 30 minutes before or 2 hours
after
and periodically during therapy.
breakfast and dinner.
Diagnoses
• Tell patient that beneficial effect of drug on cramping pain isn't likely to be noticed for 2 to 4
Lab Test Considerations: May occasionally
weeks and that it may take as long as 12 weeks.
cause anemia, hyperlipidemia, hyperuricemia, and albuminuria.
• Advise patient to avoid drinking grapefruit juice during drug therapy.
May prolong bleeding time.
• Inform patient that CV risk is unknown in patients who use drug on a long-term basis and in
Activity intolerance (Indications)
those with severe underlying heart disease.
Planning
• Tell patient that drug may cause dizziness. Caution patient not to drive or perform other
● Activity intolerance (Indications)
activities that require alertness until response to drug is known.
Implementation
● PO: Administer on an empty stomach, 1 hr before or Evaluation/Desired Outcomes

2 hr after meals ● Relief from cramping in calf muscles, buttocks,

thighs, and feet during exercise.

● Improvement in walking endurance. Therapeutic effects

may be seen in 2–4 wk.