Abciximab


Thông tin thuốc gốc
Chỉ định và Liều dùng
Intravenous
Unstable angina
Adult: In conjunction with heparin and aspirin: Patients with scheduled PCI within 24 hours: 250 mcg/kg as a bolus inj over 1 minute followed by 0.125 mcg/kg/min (max: 10 mcg/min) continuous infusion; bolus dose followed by infusion should be started up to 24 hours prior to possible PCI and concluded 12 hours after.

Intravenous
Adjunct in the prophylaxis of acute ischaemic complications in percutaneous coronary intervention
Adult: In conjunction with heparin and aspirin: 250 mcg/kg as a bolus inj over 1 minute to be given 10-60 minutes prior to PCI followed by 0.125 mcg/kg/min (max: 10 mcg/min) continuous infusion for 12 hours.
Renal Impairment
Severe (requiring haemodialysis): Contraindicated.
Hepatic Impairment
Severe: Contraindicated.
Hướng dẫn pha thuốc
IV infusion: Withdraw the required amount of drug into a syringe using 0.2 micron or 5 micron low protein-binding syringe filter (or equivalent) then inject into 250 mL of NaCl 0.9% or dextrose 5% in water to make a soln.
Chống chỉ định
Active internal bleeding or recent (w/in 6 wk) clinically-significant GI or genitourinary bleeding; history of CVA w/in 2 yr or CVA w/ significant residual neurological deficit; clotting abnormalities; recent (w/in 2 mth) intracranial or intraspinal surgery or trauma; recent (w/in 2 mth) major surgery; intracranial neoplasm, arteriovenous malformation or aneurysm; known bleeding diathesis or severe uncontrolled HTN; pre-existing thrombocytopenia; vasculitis; hypertensive retinopathy. Severe renal impairment requiring haemodialysis and severe hepatic impairment. Concomitant use of oral anticoagulants w/in 7 days (unless prothrombin time (PT) is ≤1.2 times the control PT value). IV admin of dextran before PCI or intent to use it during an intervention.
Thận trọng
Patient w/ haemorrhagic retinopathy, acute pericarditis, aortic dissection. Severe renal impairment. Pregnancy and lactation.
Phản ứng phụ
Hypotension, nausea and vomiting, back pain, chest pain, headache, haematoma, bradycardia, fever, cardiac tamponade, thrombocytopenia.
Potentially Fatal: Bleeding (during the 1st 36 hr of admin); anaphylactic reactions.
MonitoringParameters
Monitor platelet count at baseline, 2-4 hr after bolus infusion, and at 24 hr; prothrombin time, aPTT, Hb, haematocrit, fibrinogen, fibrin split products, transfusion requirements, signs of hypersensitivity reactions, guaiac stools, Hemastix® urine.
Tương tác
Increased risk of bleeding w/ other antiplatelet drugs or thrombolytics.
Potentially Fatal: Major bleeding episodes may occur w/ concomitant oral anticoagulants or IV admin of dextran.
Tác dụng
Description: Abciximab is the Fab fragment of the chimeric monoclonal antibody 7E3 which binds to glycoprotein (GP) IIb or IIIa receptor on platelet surface, thus preventing binding of fibrinogen, von Willebrand factor, and other adhesive molecules to the receptor sites, leading to inhibition of platelet aggregation.
Onset: Rapid; platelet aggregation reduced to <20% of baseline at 10 min.
Duration: Up to 72 hr for restoration of normal haemostasis.
Pharmacokinetics:
Absorption: Time to peak plasma concentration: Approx 30 min (platelet inhibition).
Distribution: Volume of distribution: 0.07 L/kg. Plasma protein binding: Mostly bound to GP IIb/IIIa receptors on platelet surface.
Metabolism: Unbound drug is metabolised via proteolytic cleavage.
Excretion: Plasma elimination half-life: Approx 30 min.
Bảo quản
Store between 2-8°C. Do not freeze or shake.
Phân loại ATC
B01AC13 - abciximab ; Belongs to the class of platelet aggregation inhibitors excluding heparin. Used in the treatment of thrombosis.
References
Anon. Abciximab. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 04/11/2015.

Buckingham R (ed). Abciximab. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 04/11/2015.

McEvoy GK, Snow EK, Miller J et al (eds). Abciximab. AHFS Drug Information (AHFS DI) [online]. American Society of Health-System Pharmacists (ASHP). www.medicinescomplete.com. Accessed 04/11/2015.

Reopro Injection, Solution (Eli Lilly and Company). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 04/11/2015.

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