Generic Name

Abciximab

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Classification

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

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.