A patient with a history of hypertension, hyperlipidemia, and asthma experiences urticaria after starting aspirin. What is the best antiplatelet therapy for her?

Given the patient's history of urticaria following the initiation of aspirin, it is crucial to avoid this medication while still providing effective antiplatelet therapy. Clopidogrel is an effective alternative for patients who cannot tolerate aspirin due to hypersensitivity reactions like urticaria.

Clopidogrel is a thienopyridine and works by inhibiting the P2Y12 receptor on platelets, thus preventing platelet activation and aggregation. Its use is well-established in a variety of cardiovascular conditions, such as in patients with coronary artery disease or those who have undergone stent placement. It is also generally well-tolerated even in patients with other underlying conditions, making it appropriate for this patient.

Therefore, transitioning to clopidogrel allows for continued antiplatelet therapy without exposing the patient to the risk of aspirin-induced hypersensitivity reactions. This option effectively balances the need for antiplatelet efficacy with the patient's safety concerns.

Other options, like decreasing the aspirin dosage or adding dipyridamole, would still involve the potential for a similar allergic reaction, as they do not eliminate the exposure to aspirin. Warfarin is an anticoagulant, not an antiplatelet agent, and while it has its own