{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T05:25:18Z","timestamp":1770355518336,"version":"3.49.0"},"reference-count":18,"publisher":"American Society of Consultant Pharmacists","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["sr care pharm"],"published-print":{"date-parts":[[2023,4,1]]},"abstract":"<jats:p><jats:bold>Background<\/jats:bold> A 76-year-old man was admitted to a local rehabilitation inpatient facility following an acute myocardial infarction. Patient history included hypertension and previous stroke. The patient was being treated with clopidogrel and aspirin for secondary stroke prevention\n along with other medications to treat hypertension. The patient admitted to using cannabidiol (CBD) oil up to three times a day for knee pain prior to acute myocardial infarction and requested to continue its use in the facility.  <jats:bold>Assessment<\/jats:bold> Prior to this hospital stay,\n the patient was able to continue activities of daily living with knee pain that was controlled by CBD oil used three times daily. The option to continue CBD oil would create a possible drug interaction with current cardiovascular medications leading to increased cardiovascular or bleeding\n risks.  <jats:bold>Outcome<\/jats:bold> The patient was advised against the use of CBD products because of potential interaction with clopidogrel and was prescribed acetaminophen for osteoarthritis (knee pain). The patient continued to improve and was discharged to his home after two weeks of rehabilitation.\n  <jats:bold>Conclusion<\/jats:bold> Based on limited pharmacodynamic and pharmacokinetic studies in older people, patients should avoid using cannabidiol and products containing its derivatives with P2Y12 inhibitors. A potential interaction between cannabidiol and its derivatives with P2Y12 inhibitors\n may increase a patient\u2019s cardiovascular or bleeding risks. Patients and health care providers must be adequately informed about potential risks associated with cannabidiol products and oral antiplatelets to prevent negative outcomes.<\/jats:p>","DOI":"10.4140\/tcp.n.2023.141","type":"journal-article","created":{"date-parts":[[2023,3,23]],"date-time":"2023-03-23T04:36:02Z","timestamp":1679546162000},"page":"141-147","source":"Crossref","is-referenced-by-count":8,"title":["Geriatric Pharmacotherapy Case Series: Potential Drug Interactions With Antiplatelet Medications and Cannabidiol\u2014A Focus on P2Y12 Inhibitors"],"prefix":"10.4140","volume":"38","author":[{"given":"Stephen A.","family":"Brown","sequence":"first","affiliation":[{"name":"McWhorter School of Pharmacy, Samford University, Birmingham, Alabama."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katie","family":"Boyd","sequence":"additional","affiliation":[{"name":"McWhorter School of Pharmacy, Samford University, Birmingham, Alabama."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angela R.","family":"Thomason","sequence":"additional","affiliation":[{"name":"McWhorter School of Pharmacy, Samford University, Birmingham, Alabama."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2625","reference":[{"key":"ref1","article-title":"A guide to CBD and cannabis for older adults.","year":"2022"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"989","DOI":"10.3390\/jcm8070989","article-title":"Potential adverse drug events and drug-drug interactions with medical and consumer cannabidiol use.","volume":"8","year":"2019","journal-title":"J Clin Med."},{"key":"ref3","doi-asserted-by":"crossref","first-page":"1127","DOI":"10.1213\/01.ANE.0000131505.03006.74","article-title":"The procoagulatory effects of delta-9-tetrahydrocannabinol in human platelets.","volume":"99","year":"2004","journal-title":"Anesth Analg."},{"key":"ref4","first-page":"332","article-title":"Cannabidiol is a potent inhibitor of the catalytic activity of cytochrome P450 2C19.","volume":"38","year":"2013","journal-title":"Drug Metab Pharmacokinet."},{"key":"ref5","volume-title":"[packet insert].","year":"2022"},{"key":"ref6","volume-title":"[packet insert].","year":"2019"},{"key":"ref7","first-page":"e123","article-title":"ACC\/AHA guideline focused update on duration of dual antiplatelet therapy in patients with coronary artery disease: a report of the American College of Cardiology\/American Heart Association Task Force on Clinical Practice Guidelines: an update of the 2011 ACCF\/ AHA\/SCAI guideline for percutaneous coronary intervention, 2011 ACCF\/AHA guideline for coronary artery bypass graft surgery, 2012 ACC\/AHA\/ ACP\/AATS\/PCNA\/SCAI\/STS guideline for the diagnosis and management of patients with stable ischemic heart disease, 2013 ACCF\/AHA guideline for the management of ST-elevation myocardial infarction, 2014 ACC\/AHA guideline for the management of patients with non\u2013ST-elevation acute coronary syndromes, and 2014 ACC\/ AHA guideline on perioperative cardiovascular evaluation and management of patients undergoing noncardiac surgery.","volume":"134","year":"2016","journal-title":"Circulation."},{"key":"ref8","first-page":"e344","article-title":"ACC\/ AHA guideline for the management of patients with non\u2013ST-elevation acute coronary syndromes: a report of the American College of Cardiology\/American Heart Association Task Force on Practice Guidelines.","volume":"130","year":"2014","journal-title":"Circulation."},{"key":"ref9","article-title":"[packet insert].","year":"2021"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"432","DOI":"10.1002\/jcph.1557","article-title":"A review of cannabis and interactions with anticoagulant and antiplatelet agents.","volume":"60","year":"2020","journal-title":"J Clin Pharmacol."},{"key":"ref11","volume-title":"[packet insert].","year":"2019"},{"key":"ref12","volume-title":"[packet insert].","year":"2021"},{"key":"ref13","first-page":"137","article-title":"Clopidogrel versus ticagrelor or prasugrel in patients aged 70 years or older with non-ST-elevation acute coronary syndrome (POPular AGE): the randomised, open-label non-inferiority trial.","volume":"395","year":"2020","journal-title":"Lancet."},{"key":"ref14","first-page":"1700","article-title":"Comparison between ticagrelor and clopidogrel in elderly patients with an acute coronary syndrome. Insights from the SWEDEHEART Registry.","volume":"143","year":"2020","journal-title":"Circulation."},{"key":"ref15","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1016\/j.cjco.2020.09.001","article-title":"A literature review of cannabis and myocardial infarction\u2014what clinicians may not be aware of.","volume":"3","year":"2021","journal-title":"CJC Open."},{"key":"ref16","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1007\/s40119-017-0102-x","article-title":"Cardiovascular complications of marijuana and related substances: a review.","volume":"7","year":"2018","journal-title":"Cardiol Ther."},{"key":"ref17","doi-asserted-by":"crossref","first-page":"6740","DOI":"10.3390\/ijms21186740","article-title":"The effects of cannabidiol, a nonintoxicating compound of cannabis, on the cardiovascular system in health and disease.","volume":"21","year":"2020","journal-title":"Int J Mol Sci."},{"key":"ref18","first-page":"149","article-title":"American College of Rheumatology\/Arthritis Foundation guideline for the management of osteoarthritis of the hand, hip, and knee.","volume":"72","year":"2019","journal-title":"Arthritis Care Res (Hoboken)."}],"container-title":["The Senior Care Pharmacist"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ingentaconnect.com\/content\/ascp\/tscp\/2023\/00000038\/00000004\/art00007","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,3,26]],"date-time":"2023-03-26T04:33:41Z","timestamp":1679805221000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ingentaconnect.com\/content\/10.4140\/TCP.n.2023.141"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,4,1]]},"references-count":18,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2023,4,1]]}},"alternative-id":["2639-9636(20230401)38:4L.141;1-"],"URL":"https:\/\/doi.org\/10.4140\/tcp.n.2023.141","relation":{},"ISSN":["2639-9636"],"issn-type":[{"value":"2639-9636","type":"print"}],"subject":[],"published":{"date-parts":[[2023,4,1]]}}}