eptifibatide

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eptifibatide

 [ep″tĭ-fib´ah-tīd]
an inhibitor of platelet aggregation used for prevention of thrombosis in patients with acute coronary syndrome or undergoing certain percutaneous coronary procedures; administered intravenously.

eptifibatide

Integrilin

Pharmacologic class: Platelet aggregation inhibitor

Therapeutic class: Antiplatelet agent

Pregnancy risk category B

Action

Decreases platelet aggregation by binding to platelet-receptor glycoprotein, preventing binding of fibrinogen to platelets, which causes thrombus formation

Availability

Injection: 10-ml vial (2 mg/ml), 100-ml vial (0.75 mg/ml)

Indications and dosages

Acute coronary syndrome (unstable angina or non-Q-wave myocardial infarction)

Adults: 180 mcg/kg I.V. bolus over 1 to 2 minutes, followed by a continuous infusion of 2 mcg/kg/minute for up to 72 hours

Prevention of thrombosis related to percutaneous coronary intervention (PCI)

Adults: 180 mcg/kg I.V. bolus immediately before PCI, then a continuous infusion of 2 mcg/kg/minute, followed by a second 180-mcg/kg bolus 10 minutes after first bolus. Continue infusion until discharge or for up to 24 hours.

Dosage adjustment

• Renal impairment

Contraindications

• Hypersensitivity to drug or its components
• Severe hypertension
• Bleeding disorders or evidence of active abnormal bleeding within previous 30 days
• Renal dialysis
• Recent cerebrovascular accident
• Recent surgery
• Current or planned administration of another parenteral Gp IIb/IIIa inhibitor

Precautions

Use cautiously in:
• renal insufficiency
• creatinine level below 2 mg/dl
• platelet count below 100,000/mm3
• elderly patients
• pregnant or breastfeeding patients
• children (safety and efficacy not established).

Administration

• Withdraw single bolus dose from 10-ml vial into syringe, and give by I.V. push over 1 to 2 minutes. Follow single I.V. bolus dose with continuous I.V. infusion given undiluted from 100-ml vial spiked with infusion set connected to infusion control device.
• Don't administer through same I.V. line as furosemide.

Adverse reactions

CNS: headache, dizziness, asthenia, syncope

CV: hypotension

GI: nausea, diarrhea, constipation

GU: hematuria

Hematologic: bleeding tendency, thrombocytopenia

Skin: flushing

Other: bleeding at femoral access site

Interactions

Drug-drug.Clopidogrel, dipyridamole, nonsteroidal anti-inflammatory drugs, oral anticoagulants, thrombolytics, ticlopidine: increased risk of bleeding Other platelet aggregation inhibitors: serious bleeding

Drug-diagnostic tests.Platelets: decreased count

Drug-herbs.Most commonly used herbs: increased anticoagulant effect of eptifibatide

Patient monitoring

• Monitor vital signs and assess cardiovascular status, especially for syncope and hypotension.
• Monitor coagulation studies, CBC, and platelet count. Watch for signs and symptoms of abnormal bleeding or bruising and hematuria.
• Check carefully for bleeding at all sites of invasive procedures, particularly femoral access site.

Patient teaching

• Tell patient drug may cause serious adverse effects but can help prevent a heart attack. Reassure him that he'll be closely monitored during therapy.

Instruct patient to immediately report fainting or abnormal bruising or bleeding.
• Teach patient safety measures to avoid bruising or bleeding.
• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs, tests, and herbs mentioned above.

eptifibatide

/ep·ti·fib·a·tide/ (ep″tĭ-fib´ah-tīd) an inhibitor of platelet aggregation used for the prevention of thrombosis in patients with acute coronary syndrome or undergoing certain percutaneous coronary procedures.

eptifibatide

an antiplatelet agent.
indications It is used to treat acute coronary syndrome, including patients with percutaneous coronary intervention.
contraindications The following factors prohibit its use: known hypersensitivity to this drug, active internal bleeding, history of bleeding, stroke within 1 month, major surgery with severe trauma, severe hypotension, history of intracranial bleeding, intracranial neoplasm, arteriovenous malformation/aneurysm, aortic dissection, and dependence on renal dialysis.
adverse effects Life-threatening effects of this drug are stroke and bleeding. Hypotension is another serious adverse reaction.

eptifibatide

Integrilin® Cardiology An antithrombotic GP IIb/IIIa receptor antagonist that blocks fibrinogen and von Willebrand factor from binding to the surface of activated platelets

antiplatelet therapy

agents that reduce platelet aggregation and inhibit arterial thrombus formation in an area of the circulation where other anticoagulants have reduced effect; e.g. low-dose aspirin (75 mg daily), clopidogrel (± low-dose aspirin), dipyridamole (used to prevent thromboembolism in patients with prosthetic heart valves), abciximab, eptifibatide and tirofiban
References in periodicals archive ?
Patients who received a IIb/IIIa inhibitor during initial treatment were treated with either epifibatide or tirofiban.