ReoPro

ReoPro

 
trademark for a preparation of abciximab, an antithrombotic agent.

abciximab

ReoPro (CA)

Pharmacologic class: Platelet aggregation inhibitor

Therapeutic class: Antithrombotic, antiplatelet drug

Pregnancy risk category C

Action

Inhibits fibrinogen binding and platelet-platelet interaction by impeding fibrinogen binding to platelet receptor sites, thereby prolonging bleeding time

Availability

Injection: 2 mg/ml (5-ml vials containing 10 mg)

Indications and dosages

Adjunct to aspirin and heparin to prevent acute cardiac ischemic complications in patients undergoing percutaneous coronary intervention (PCI)

Adults: 0.25 mg/kg I.V. bolus given 10 to 60 minutes before start of PCI, followed by infusion of 0.125 mcg/kg/minute for 12 hours. Maximum dosage is 10 mcg/minute.

Adjunct to aspirin and heparin in patients with unstable angina who haven't responded to conventional medical therapy and will undergo PCI within 24 hours

Adults: 0.25 mg/kg I.V. bolus, followed by 18- to 24-hour infusion of 10 mcg/minute, ending 1 hour after PCI

Contraindications

• Hypersensitivity to drug or murine proteins
• Active internal bleeding
• Bleeding diathesis
• Severe, uncontrolled hypertension
• Thrombocytopenia (< 100,000 cells/mm3)
• Neutropenia
• Aneurysm
• Arteriovenous malformation
• History of cerebrovascular accident
• Oral anticoagulant therapy within past 7 days (unless prothrombin time is < 1.2 times control)

Precautions

Use cautiously in:
• patients receiving drugs that affect hemostasis (such as thrombolytics, anticoagulants, or antiplatelet drugs)
• pregnant or breastfeeding patients.

Administration

• I.V. bolus dose may be given undiluted. For I.V. infusion, further dilute the desired dose with normal saline or D5W.
• Give through separate I.V. line with no other drugs.
• Avoid noncompressible I.V. sites, such as subclavian or jugular vein.

Stop continuous infusion after failed PCI.
• Restrict patient to bed rest for 6 to 8 hours after drug withdrawal or 4 hours after heparin withdrawal (whichever occurs first).
• After catheter removal, apply pressure to femoral artery for at least 30 minutes.

Adverse reactions

CNS: dizziness, anxiety, agitation, abnormal thinking, hypoesthesia, difficulty speaking, confusion, weakness, cerebral ischemia, coma

CV: pseudoaneurysm, palpitations, vascular disorders, arteriovenous fistula, hypotension, peripheral edema, weak pulse, intermittent claudication, bradycardia, ventricular or supraventricular tachycardia, atrial fibrillation or flutter, atrioventricular block, nodal arrhythmias, pericardial effusion, embolism, thrombophlebitis

EENT: abnormal or double vision

GI: nausea, vomiting, diarrhea, constipation, dyspepsia, ileus, gastroesophageal reflux, enlarged abdomen, dry mouth

GU: urinary tract infection, urine retention or urinary incontinence, painful or frequent urination, abnormal renal function, cystalgia, prostatitis Hematologic: anemia, leukocytosis, thrombocytopenia, bleeding

Metabolic: diabetes mellitus, hyperkalemia

Musculoskeletal: myopathy, myalgia, increased muscle tension, reduced muscle stretching ability

Respiratory: pneumonia, crackles, rhonchi, bronchitis, pleurisy, pleural effusion, bronchospasm, pulmonary edema, pulmonary embolism

Skin: pallor, cellulitis, petechiae, pruritus, bullous eruptions, diaphoresis

Other: abscess, peripheral coldness, development of human antichimeric antibodies

Interactions

Drug-drug.Drugs that affect hemostasis (such as aspirin, dextran, dipyridamole, heparin, nonsteroidal anti-inflammatory drugs, oral anticoagulants, thrombolytics, and ticlopidine): increased bleeding risk

Drug-diagnostic tests.Activated partial thromboplastin time (APTT), clotting time, prothrombin time (PT): increased values

Platelets: decreased count

Patient monitoring

• Assess platelet count before, during, and after therapy.

Monitor catheter insertion site frequently for bleeding.

During catheter insertion and for 6 hours after catheter removal, frequently monitor digital pulse in leg where catheter was inserted.
• Monitor CBC, PT, APTT, and International Normalized Ratio.
• Minimize arterial or venous punctures, automatic blood pressure cuff use, I.M. injections, nasotracheal or nasogastric intubation, and urinary catheterization.
• Use indwelling venipuncture device, such as heparin lock, to draw blood.

Patient teaching

• Tell patient what to expect during and after drug administration.
• Advise patient to minimize GI upset by eating small, frequent servings of food and drinking plenty of fluids.

Instruct patient to immediately report unusual bleeding or bruising.
• Caution patient to avoid activities that may cause injury. Advise him to use soft toothbrush and electric razor to avoid gum and skin injury.
• Inform patient that he'll undergo regular blood testing during therapy.
• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs and tests mentioned above.

ReoPro

(rē′ō-prō′)
A trademark for the drug abciximab.

ReoPro

a trademark for a preparation of an antithrombotic agent (abciximab).

ReoPro®

Abciximab, see there.

Reopro

A brand name for the drug ABCIXIMAB.
References in periodicals archive ?
In the TEG functional fibrinogen test, the tissue factor is used for coagulation activation described classically as extrinsic, with the platelet function inhibited by ReoPro (abciximab, Eli Lilly and Company, Indianapolis, Indiana), a GPIIb/IIIa inhibitor, so the resulting contribution of the functional fibrinogen to clot strength can be viewed.
I am fairly comfortable with medications related to ischemic strokes (tpa, reopro, heparin, blood pressure medication, antilipids, blood glucose management, etc.
The primary endpoint was designed to show a 40% decline in bleeding events with ALX-0081 compared with ReoPro, but results showed that there was no statistically significant difference between the total number of bleeding events for the two compounds.
The hemiparesis was resolved by Reopro bolus and subsequent infusion.
Because of residual clot, the IIb/IIIa inhibitor, ReoPro, was given, and discontinued the same day.
VerifyNow is a rapid, simple, and accurate system for measuring individual response to every major antiplatelet medication, including aspirin, Plavix, ReoPro, and Integrilin.
s major products include Prozac (an antidepressant), Axid (antiulcer), Kefzol, Ceclor, Lorabid (antibiotics), Zyprexa (schizophrenia), Humatrope (human growth hormone), Humulin (insulin), Reopro (angioplasty) and Evista (osteoporosis).
The list of these "silver bullets" now includes Herceptin for a type of breast cancer, Rituxan for a type of lymphoma, ReoPro for clot prevention during coronary artery intervention, and Remicade for Crohn's disease.
Angioplasty patients at 100 Top hospitals were significantly more likely to be treated with stents and expensive new drugs like Reopro and Integrelin than their counterparts at average hospitals, Chenoweth quotes still another Solucient data analysis.
Stenting made a huge improvement, as did the addition of certain drugs like ReoPro.
ENTIRE (ENoxaparin and TNK-tPA with or without GP IIb/IIIa Inhibitor as REperfusion strategy in ST elevation MI), also referred to as TIMI 23, will examine TIMI flows through coronary angiography, utilizing varying dosing regimens of TNKase(TM) (Tenecteplase), the low-molecular-weight heparin Lovenox, the anti-platelet agent ReoPro, and heparin sodium.