Antiplatelet Medicine Cards
The UKCPA Cardiac Group has launched a card for patients to improve communication about the intended length of treatment with antiplatelet medicine predominantly following percutaneous coronary intervention.
Combination antiplatelet therapy (with aspirin and, for example, clopidogrel or prasugrel) is established for the prevention of coronary thrombi in patients with coronary artery stents and acute coronary syndromes. The length of the course depends on factors including the pre-existing clinical condition of the patient, the procedure undertaken and the type of stent deployed. Failure to communicate adequately the intended duration of combination therapy to the patient and the primary care physician can result in inappropriate early discontinuation of treatment, increasing the risk of intra-stent thrombosis and subsequent myocardial infarction. This appears to be particularly important with drug-eluting stents.
Providing patients with written information from an interventional centre on the expected length of therapy may help reduce the incidence of inappropriate discontinuation or prolongation of therapy.
Originally designed by Sotiris Antoniou of the pharmacy department at the Barts and The London Heart Centre, the antiplatelet card has been endorsed by the British Cardiovascular Society and British Cardiac Intervention Society. The UKCPA is making the card available to ensure that patients have written information on the reason why an antiplatelet drug has been started, their daily dose, the drug’s concurrent use with aspirin and the planned duration of therapy. The card also provides details on possible adverse effects and potential interactions with other medicine, and highlights the need to consult a doctor before any surgical procedures.
The card is available from the UKCPA by emailing firstname.lastname@example.org or faxing 0116 2889891. Kindly ensure that you include the amount of cards required, invoice and dispatch address and any purchase order numbers required.
(Postage and Packing is applicable only. UKCPA is not VAT registered).
For current prices, please click here: Antiplatelet Medicine Card Price List April 2013
Dronedarone Medicine Cards
The UKCPA is pleased to announce an endorsement of the recently launched dronedarone card which is to be given to patients once they have been initiated on dronedarone. The card has been developed in response to the MHRA monitoring requirements.
The endorsement is in recognition that the card will help facilitate the safe use of dronedarone and the documentation of the monitoring requirements such that patients remain eligible for dronedarone treatment according to the revised prescribing information with regular monitoring of cardiac, liver, and renal function during treatment.
The card empowers patients’ ownership of their care and can show the card to any healthcare provider who is involved in their care. The endorsement is not an indication that dronedarone is to be used in preference over other antiarrhythmics.
MHRA Advice for healthcare professionals:
Dronedarone is now contraindicated in patients with:
- Unstable haemodynamic conditions
- History of, or current, heart failure or left ventricular systolic dysfunction
- Permanent AF (ie, duration ≥6 months or unknown, and attempts to restore sinus rhythm no longer considered by physician)
- Liver and lung toxicity related to previous use of amiodarone
- Patients should receive regular cardiac examinations, including an ECG at least every 6 months, to identify those who revert to AF. Discontinuation of dronedarone should be considered for these patients
- Discontinue treatment if the patient develops permanent AF
- Patients should be carefully evaluated for symptoms of heart failure during treatment
- Patients should be appropriately anticoagulated as per clinical AF guidelines. International Normalised Ratio (INR) should be closely monitored after initiating dronedarone in patients taking vitamin K antagonists as per the prescribing information for these products
- Liver-function tests should be done: before starting treatment with dronedarone; after 1 week of treatment; after 1 month of treatment; then every month for 6 months; at month 9; at month 12; and periodically thereafter
- Plasma creatinine values should be measured before and 7 days after initiation of dronedarone, and renal function should be monitored periodically afterwards. Discontinue treatment in any patients with further elevations of serum creatinine
- Cases of interstitial lung disease, including pneumonitis and pulmonary fibrosis, have been reported in association with dronedarone. Onset of dyspnoea or non-productive cough may be related to pulmonary toxicity. If pulmonary toxicity is suspected during treatment, relevant lung examinations should be considered and treatment discontinued if confirmed
Advice for patients:
- Patients should be advised to make a routine appointment to discuss their treatment with the treating physician, but should not stop taking dronedarone unless told to do so
Reporting of suspected adverse reactions:
- Please report all suspected adverse reactions to dronedarone via the Yellow Card Scheme
Please note: The UKCPA requires full payment for Antiplatelet Medicine Cards orders prior to despatch. Once payment has been received, we will email you confirmation of when your order has been processed. We will endeavour to despatch all orders within 5 working days of confirmed payment.