Home Drug Guide Eptifibatide

Drug Guide

Generic Name

Eptifibatide

Brand Names Integrilin

Classification

Therapeutic: Antiplatelet agent, Glycoprotein IIb/IIIa inhibitor

Pharmacological: Receptor antagonist

FDA Approved Indications

Prevention of cardiac ischemic complications in patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI)

Mechanism of Action

Eptifibatide is a cyclic heptapeptide that reversibly inhibits the glycoprotein IIb/IIIa receptor on platelets, preventing fibrinogen binding and platelet aggregation.

Dosage and Administration

Adult: Initial dose of 180 mcg/kg IV bolus, followed by an infusion of 2 mcg/kg/min, continued for up to 18-24 hours or duration of PCI.

Pediatric: Not approved for pediatric use.

Geriatric: Use with caution due to increased bleeding risk; dose adjustment not typically required but monitor closely.

Renal Impairment: Reduce dose or extend dosing intervals; specific adjustments depend on severity.

Hepatic Impairment: No specific recommendations available.

Pharmacokinetics

Absorption: Administered intravenously; no oral absorption.

Distribution: Widely distributed within the vascular compartment.

Metabolism: Metabolized by proteolytic enzymes; not significantly hepatically metabolized.

Excretion: Primarily excreted unchanged in urine.

Half Life: Approximately 2.5 hours.

Contraindications

Active bleeding
History of hemorrhagic stroke
Recent severe trauma or surgery
Uncontrolled hypertension

Precautions

Use cautiously in patients with bleeding disorders, severe HTN, or recent major surgery. Monitor closely for bleeding events.

Adverse Reactions - Common

Bleeding (including minor and major hemorrhage) (Common)
Back pain, hypotension (Less common)

Adverse Reactions - Serious

Major bleeding, thrombocytopenia, allergic reactions (Serious but less common)

Drug-Drug Interactions

Other antithrombotic agents, anticoagulants, NSAIDs, antidepressants

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

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

Diagnoses:

Risk for bleeding
Impaired tissue perfusion

Implementation: Administer as prescribed, monitor for bleeding, and ensure quick access to interventions if bleeding occurs.

Evaluation: Assess for absence of bleeding complications and therapeutic efficacy.

Patient/Family Teaching

Report any unusual bleeding or bruising.
Use caution with activities that may cause injury.
Inform healthcare providers about all medications taken.

Special Considerations

Black Box Warnings:

Significant risk of bleeding.

Genetic Factors: None specified.

Lab Test Interference: May interfere with platelet function tests.

Overdose Management

Signs/Symptoms: Excessive bleeding, hypotension, hematoma formation.

Treatment: Discontinue drug, provide supportive care, consider platelet transfusion if bleeding is severe.

Storage and Handling

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

Stability: Stable until the expiration date on the package.