Nurses Compass
Drug Guide
Cangrelor
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/ADrug-Herb Interactions
N/ANursing 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.