Abciximab
Anticoagulant/Antiplatelet · Antiplatelet
Indications
Adjunct to heparin and aspirin to prevent ischaemic cardiac complications in high risk patients undergoing coronary angioplasty. To reduce risk of myocardial infarction in patients with unstable angina scheduled for coronary angioplasty who do not respond to full conventional therapy.
Dosage
Prevention of ischaemic cardiac complications: Adults: 0.25 mg/kg by bolus IV inj. 10-60 min prior to PTCA and immediately followed by a 0.125 mcg/kg/min. continuous IV infusion for 12 hr. Short-term prevention of myocardial infarction in patients with unstable angina: Adults: 0.25 mg/kg by bolus IV inj up to 24 hr prior to PTCA and immediately followed by a 0.125 mcg/kg/min. Continuous IV infusion for 12 hr after the intervention. Administer oral aspirin at a dose of not less than 300 mg daily. Administer Heparin in a low-dose weight adjusted regimen: see literature. Elderly: Over 80 yr, not recommended. Children: Not recommended.
Administration
Bolus dose: Aseptically withdraw the necessary amount of abciximab (2 mg/ mL) for the bolus dose through a 0.22 micron filter into a syringe; the bolus should be administered 10-60 min before procedure. Continuous infusion: Aseptically withdraw 4.5 mL (9 mg) of abciximab for the infusion through a 0.22 micron filter into a syringe; inject this into 250 mL of NS or D5W to make a solution with a final concentration of 35 mcg/ mL. Infuse at a rate of 17 mL/hour (10 mcg/min) for 12 hour via pump; filter all infusions.
Adverse Effects
Bleeding complications, hypertension, nausea, vomiting thrombocytopenia, haematoma, bradycardia, fever, vascular disorders.
Risk Factor (Pregnancy/Lactation)
Pregnancy: Risk cannot be ruled out. Lactation: Caution advised or effect undetermined. Contraindications: Sensitivity to murine monoclonal antibodies. Active internal haemorrhage, cerebrovascular accident within last 2 years, recent intracranial or intraspinal surgery or trauma, recent major surgery, intracranial neoplasm, arteriovenous malformation or aneurysm, bleeding diathesis, severe uncontrolled hypertension, thrombocytopenia, vasculitis, hypertensive or diabetic retinopathy. Previous monoclonal antibody therapy. Precautions: Incidence of bleeding reduced by use of low-dose weight adjusted heparin, early sheath removal and improved patient and access site management, see literature. Risk of anaphylaxis, cardio-pulmonary resuscitation facilities must be on hand. Perform full blood tests and platelet counts before and after therapy, transfuse platelets if count drops below 50,000…
Interactions
Additive effects with thrombolytics, anticoagulants, antiplatelet agents.
Advice to Patient
There is a tendency to bleed easily so injury from falls can be prevented by maintaining bed rest and from bleeding by keeping limb immobile while catheter sheath is in place.
Pharmacokinetics
Onset: Rapid. Duration: Platelet function recovery: 24-48 hrs, may be up to 72 hrs for restoration of normal haemostasis. Metabolism: Proteolytic cleavage metabolizes unbound abciximab. Half-life elimination: Plasma: Approx. 30 min. Dissociation half-life from GP IIb/IIIa receptors: Up to 4 hrs. Time to peak: Platelet inhibition: Approx. 30 min.
Brands with this active ingredient
Compiled by Healify Pharmacy from published drug references. How we compile it →
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