Home Drug Guide Cangrelor

Drug Guide

Generic Name

Cangrelor

Brand Names Kengreal

Classification

Therapeutic: Antiplatelet agent

Pharmacological: P2Y12 receptor antagonist, antiplatelet agent

FDA Approved Indications

  • Prevention of thrombotic cardiovascular events in patients undergoing percutaneous coronary intervention (PCI)

Mechanism of Action

Cangrelor is a rapid, reversible P2Y12 ADP receptor antagonist that inhibits platelet activation and aggregation, thereby reducing the risk of thrombotic events during PCI.

Dosage and Administration

Adult: Initial IV bolus of 30 mcg/kg, followed by continuous infusion of 4 mcg/kg/min during PCI; duration typically not exceeding 2 hours or the duration of the PCI procedure.

Pediatric: Not approved for pediatric use.

Geriatric: No specific dosage adjustments required, but consider renal function and bleeding risk.

Renal Impairment: Adjustments are not specified; use with caution in severe renal impairment.

Hepatic Impairment: No specific data; use caution as metabolism may be affected.

Pharmacokinetics

Absorption: Rapid onset upon IV administration.

Distribution: Rapid distribution with a volume of distribution approximately 11 L.

Metabolism: Rapid dephosphorylation by plasma phosphatases to inactive metabolites.

Excretion: Metabolites excreted renally.

Half Life: Approximate plasma half-life of 3-5 minutes, allowing for quick recovery of platelet function after infusion cessation.

Contraindications

  • Active bleeding
  • History of hemorrhagic diatheses
  • Severe thrombocytopenia

Precautions

  • Use with caution in patients at risk of bleeding, recent surgery, or trauma; monitor for bleeding complications.

Adverse Reactions - Common

  • Bleeding, including major bleeding (Common)
  • Headache (Uncommon)

Adverse Reactions - Serious

  • Major bleeding leading to transfusion or death (Less common)
  • Hypotension (Uncommon)

Drug-Drug Interactions

  • Other antithrombotic agents, anticoagulants, and agents affecting platelet function may increase bleeding risk.

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor bleeding signs, vital signs, and platelet counts.

Diagnoses:

  • Risk for bleeding related to pharmacologic antiplatelet activity.

Implementation: Administer as prescribed, monitor for bleeding, and ensure readiness for emergency interventions.

Evaluation: Assess for signs of bleeding, effectiveness in preventing thrombotic events, and adverse effects.

Patient/Family Teaching

  • Inform about increased bleeding risk and signs of bleeding to report.
  • Do not perform activities that increase risk of injury.
  • Report any unusual bleeding or bruising immediately.

Special Considerations

Black Box Warnings:

  • Increased risk of bleeding; use only in appropriate settings.
  • Not for use in patients with active pathological bleeding.

Genetic Factors: No current genetic considerations specified.

Lab Test Interference: May prolong bleeding time; interpret laboratory results with caution.

Overdose Management

Signs/Symptoms: Excessive bleeding, hemorrhage.

Treatment: Discontinue cangrelor; provide supportive care, blood products if necessary; no specific antidote exists.

Storage and Handling

Storage: Store at room temperature, protected from moisture and light.

Stability: Stable in unopened vials for recommended storage period as per manufacturer.

🛡️ 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.