week 8 pam 103

Glycoprotein IIb/IIIa inhibitor

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

Adjunct to percutaneous coronary intervention

• Internal bleeding (within 6 weeks)
• GI/GU bleeding, stroke (within two years)
• Bleeding disorder, recent major surgery (within 6 weeks)

• should be used with caution in pt with higher risk of bleeding.
• Allergic reaction have been known to occur

• Increased rick of bleeding
• Nausea 
• Vomiting
• Abdominal pain 
• Anemia
• Pain
• Swelling

UA/stemi with planed PCI in <24 hours: 0.25 mg/kg IV bolus administered 10-60 min prior to PCI followed by a contunios infushion of 0.125 mcg/kg/min for 12 hours (max dose of 10 mcg/min)

IV

not routinely use

Glycoprotein IIb/IIIa inhibitor

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

ACS pt undergoing PCI as well as those who will be managed medically

A history of bleeding diathesis, or evidence of active abnormal bleeding within the previous 30 days

Severe hypertension (systolic blood pressure > 200 mm Hg or diastolic blood pressure > 110 mm Hg) not adequately controlled

on anti-hypertensive therapy

Major surgery within the preceding 6 weeks

History of stroke within 30 days or any

history of hemorrhagic stroke

Current or planned administration of another parenteral GP IIb/IIIa inhibitor

Dependency on renal dialysis

should be used with caution in pt with higher risk of bleeding.

• ACS: 180 mcg as a bolus dose, followed by 2 mcg/kg/min dose until discharge or surgery ( upto 72 hours)
• PCI: 180 mcg/kg as a bolus dose immediate before PCI, followed by 2 mcg/kg/min infusion followed by a second bolus 180 mcg/kg is give 10 min after first bolus. should contune for 18-24 hours (minimum of 12 hours)

IV

not routinely used

Glycoprotein IIb/IIIa inhibitor

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

ACS

• Internal bleeding (within 6 weeks)
• GI/GU bleeding, stroke (within two years)
• Bleeding disorder, recent major surgery (within 6 weeks)

• should be used with caution in pt with higher risk of bleeding.
• Allergic reaction have been known to occur

• Increased rick of bleeding
• Nausea 
• Vomiting
• Abdominal pain 
• Anemia
• Pain
• Swelling

0.4 mcg/kg/minfor 30 min continued at 0.1 mcg/kg/min

IV

not indicated

Fibrinolytic

Dissolves blood clots

Acute Myocardial Infraction

• May be ineffective if administered with in 12 months of prior Streptokinase or anisterplase therapy
• Anti-arrhythmic and resuceitative meds should be available

• Bleeding 
• Allergic reaction
• anaphylaxis 
• fever
• Nausea and vomiting

1.5 million units over 1 hour

IV drip

not recommend