Home Drug Guide Tirofiban Hydrochloride

Drug Guide

Generic Name

Tirofiban Hydrochloride

Brand Names Aggrastat

Classification

Therapeutic: Antiplatelet agent, Glycoprotein IIb/IIIa inhibitor

Pharmacological: Integrin receptor antagonist

FDA Approved Indications

  • Reduction of thrombotic cardiovascular events in patients with unstable angina undergoing percutaneous coronary intervention (PCI).

Mechanism of Action

Tirofiban is a non-peptide antagonist of the glycoprotein IIb/IIIa receptor on platelets, inhibiting fibrinogen binding and platelet aggregation, thereby preventing thrombus formation.

Dosage and Administration

Adult: Administer an initial bolus of 25 mcg/kg over 3 minutes, followed by a continuous infusion of 0.15 mcg/kg/min. Adjust based on bleeding risk and clinical response.

Pediatric: Not recommended; data insufficient.

Geriatric: Use with caution; consider renal function. Adjust dosage as necessary.

Renal Impairment: Reduce infusion rate in patients with moderate to severe renal impairment due to decreased clearance.

Hepatic Impairment: No specific adjustment recommended.

Pharmacokinetics

Absorption: Administered intravenously; bioavailability is 100%.

Distribution: Volume of distribution approximately 21 liters; minimal protein binding.

Metabolism: Metabolized minimally; primarily cleared unchanged.

Excretion: Renal excretion of unchanged drug; important for dose adjustment.

Half Life: Approximately 2 hours.

Contraindications

  • Active internal bleeding
  • History of hemorrhagic stroke
  • Recent major surgery or trauma
  • Severe uncontrolled hypertension

Precautions

  • Use caution in patients with bleeding disorders or recent surgical procedures.
  • Monitor closely for signs of bleeding.
  • Use with caution in elderly patients.

Adverse Reactions - Common

  • Bleeding (including minor bleeding) (Common)
  • Hypotension (Common)
  • Headache (Common)

Adverse Reactions - Serious

  • Major bleeding (Uncommon but serious)
  • Thrombocytopenia (Rare)

Drug-Drug Interactions

  • Other anticoagulants (e.g., heparin, warfarin)
  • Other antiplatelet agents

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor bleeding signs, blood pressure, and platelet count regularly.

Diagnoses:

  • Risk for bleeding related to antiplatelet therapy
  • Impaired tissue perfusion due to bleeding

Implementation: Administer as prescribed, ensure proper infusion techniques, and monitor patient closely.

Evaluation: Assess for bleeding complications and efficacy of therapy.

Patient/Family Teaching

  • Report any unusual bleeding or bruising immediately.
  • Avoid activities that increase bleeding risk.
  • Inform healthcare providers of all medications being taken.

Special Considerations

Black Box Warnings:

  • Significant risk of bleeding; use only as indicated.

Genetic Factors: No specific genetic considerations.

Lab Test Interference: May cause false-positive results in urine bilirubin tests.

Overdose Management

Signs/Symptoms: Excessive bleeding, hypotension, bleeding at surgical sites.

Treatment: Discontinue drug immediately, provide supportive care, and administer platelet transfusions if needed.

Storage and Handling

Storage: Store at room temperature (20-25°C); protect from light.

Stability: Stable for the duration specified on the package when stored properly.

🛡️ 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.