DrugindexOnline^{2nd edition}

Pronouncation: (ab-SICK-sih-mab)
Class: Glycoprotein IIb/IIIa inhibitor

Trade Names:
ReoPro
- Injection 2 mg/mL

Mechanism of Action

Pharmacology

Binds to glycoprotein IIb/IIIa receptors on surface of platelets, thereby preventing platelet aggregation.

Pharmacokinetics

Distribution

Rapidly binds to glycoprotein IIb/IIIa receptors.

Elimination

Initial t _½ is less than 10 min. Second phase t _½ is about 30 min.

Duration

Platelet function generally recovers over 48 h.

Indications and Usage

Adjunct to percutaneous coronary intervention (PCI) to prevent ischemic complications in patients at high risk of abrupt closure of the treated vessel. Intended for use with aspirin and heparin.

Contraindications

Active internal bleeding; recent (6 wk) GI/GU bleeding, major surgery, or trauma; history of CVA in the past 2 yr of CVA with significant residual neurological deficit; use of oral anticoagulants within 7 days unless prothrombin time is less than 1.2 times control; thrombocytopenia; severe uncontrolled hypertension; vasculitis; intracranial neoplasm, aneurysm, or arteriovenous malformation; or the recent or current use of IV dextran.

Dosage and Administration

Adults

IV 0.25 mg/kg bolus 10 to 60 min before PCI followed by continuous infusion of 0.125 mcg/kg/min (to a max of 10 mcg/min) for 12 h.

General Advice

• Use only normal saline or D5W for IV infusion. Add no other medication for the infusion.
• Do not use drug if vial contains visibly opaque particles.
• Withdraw medication through a 0.2 or 2.2 micron filter.
• Administer drug through a separate IV line with filter.
• Avoid noncompressible sites when obtaining IV access.

Storage/Stability

Store vials at 2° to 8°C (36° to 46°F). Do not freeze. Do not shake. Discard any unused portion.

Drug Interactions

None well documented.

Laboratory Test Interactions

None well documented.

Adverse Reactions

Cardiovascular

Hypotension; bradycardia; atrial fibrillation; pulmonary edema; AV block; supraventricular tachycardia.

CNS

Hypesthesia; headache; confusion; dizziness.

EENT

Abnormal vision.

GI

Nausea, vomiting.

Hematologic

Bleeding; thrombocytopenia; anemia; leukocytosis.

Respiratory

Pleural effusion; pneumonia.

Miscellaneous

Pain; peripheral edema.

Precautions

Monitor Bleeding If serious bleeding occurs that is not controlled with pressure, stop infusion of abciximab and heparin. Platelet counts Prior to administration, check platelet count, PTT, and APTT. Monitor during and after treatment.

Pregnancy

Category C .

Lactation

Undetermined.

Children

Safety and efficacy not established.

Readministration

Abciximab may cause antibody development. Readministration may be associated with allergic reactions.

Bleeding

Because risk of bleeding is increased, use cautiously, if at all, with thrombolytics, oral anticoagulants, NSAIDs, dipyridamole, and ticlopidine. Institute bleeding precautions.

Thrombocytopenia

Monitor platelet counts.

Patient Information

• Advise patient to report any bleeding or bruising to health care provider immediately.