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.