Home Drug Guide Abciximab

Drug Guide

Generic Name

Abciximab

Brand Names ReoPro

Classification

Therapeutic: Antiplatelet agent, Glycoprotein IIb/IIIa inhibitor

Pharmacological: Monoclonal antibody

FDA Approved Indications

  • Prevention ofischemic complications in patients undergoing percutaneous coronary intervention (PCI) including angioplasty, stent placement, or atherectomy

Mechanism of Action

Abciximab is a monoclonal antibody fragment that binds to the glycoprotein IIb/IIIa receptor on platelets, inhibiting fibrinogen binding and thereby preventing platelet aggregation.

Dosage and Administration

Adult: Initial IV bolus of 0.25 mg/kg administered 10-60 minutes before PCI, followed by an infusion of 10 mcg/min for 12 hours.

Pediatric: Not typically used in pediatric patients.

Geriatric: Use caution; monitor for bleeding risk, adjust dosage as needed.

Renal Impairment: Use with caution; no specific dosing adjustment, but assess renal function.

Hepatic Impairment: No specific recommendations; use caution.

Pharmacokinetics

Absorption: Rapid onset following IV administration.

Distribution: Extensive, with a volume of distribution of approximately 10-20 mL/kg.

Metabolism: Cleaved by proteolytic enzymes; not significantly metabolized by liver.

Excretion: Excreted primarily as peptides in urine.

Half Life: about 10-30 minutes for the plasma concentration decline, but platelet function is inhibited for 24-48 hours.

Contraindications

  • Active bleeding
  • History of hemorrhagic stroke
  • Recent major surgery or trauma

Precautions

  • Use caution in patients with bleeding diatheses, uncontrolled hypertension, severe hypertension, or recent cerebrovascular hemorrhage.

Adverse Reactions - Common

  • Bleeding (Very common)
  • Hypotension (Common)

Adverse Reactions - Serious

  • Bleeding complications, including intracranial bleeding (Rare to uncommon)
  • Allergic reactions including anaphylaxis (Rare)

Drug-Drug Interactions

  • Other anticoagulants like heparin, warfarin, or thrombolytics increase bleeding risk.

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor for signs of bleeding, blood pressure, and platelet counts.

Diagnoses:

  • Risk for hemorrhage
  • Impaired tissue perfusion related to bleeding

Implementation: Administer as prescribed, monitor coagulation parameters and platelet counts regularly, observe for bleeding signs.

Evaluation: Assess for any bleeding, monitor platelet recovery, ensure no adverse reactions occur.

Patient/Family Teaching

  • Report any signs of bleeding such as bleeding gums, unexplained bruising, or blood in urine/stool.
  • Avoid activities that could cause injury.
  • Be aware of signs of bleeding or allergic reactions and seek immediate medical attention.

Special Considerations

Black Box Warnings:

  • Significant risk of bleeding; administer with caution, especially in patients at risk for hemorrhage.

Genetic Factors: No specific genetic testing recommended.

Lab Test Interference: May interfere with platelet function tests.

Overdose Management

Signs/Symptoms: Severe bleeding, unexplained bleeding, hemorrhagic shock.

Treatment: Discontinue abciximab, provide supportive care, and manage bleeding according to protocol; no specific antidote.

Storage and Handling

Storage: Store vials at 2-8°C; protect from light.

Stability: Stable until expiration date when refrigerated.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.