Summary

GP IIb/IIIa inhibitors are a class of drugs that includes tirofiban, abciximab (ab SIX i mab), and eptifibatide (ep TIF i ba tide). These drugs work to inhibit platelet aggregation, by blocking the interaction of glycoprotein IIb/IIIa on platelets with fibrinogen molecules that would otherwise lead to the creation of a platelet plug during blood clot formation. GP IIb/IIIa inhibitors are indicated in patients with acute coronary syndrome, especially in patients who are undergoing coronary artery stenting procedures.

Key Points

• GP IIb/IIIa Inhibitors
  • Drug Names
    • Abciximab
    • Eptifibatide
    • Tirofiban
  • Mechanism
    • Competitively inhibit glycoprotein IIb/IIIa receptors on platelets
      • Prevents platelet aggregation
        • Normally, aggregation occurs via fibrinogen cross-linking using glycoprotein IIb/IIIa receptors
      • Similar effect to Glanzmann’s Thrombasthenia
        • Bleeding disorder in which platelets lack glycoprotein IIb/IIIa receptors
  • Clinical Use
    • Prevention of thrombosis for acute coronary syndrome
      • Especially during/after percutaneous coronary interventions (PCI), also known as stenting
      • Used to treat unstable angina and acute coronary syndrome (e.g. NSTEMI)
      • Used in high risk patients
        • Continued ischemia despite dual antiplatelet therapy
        • Large coronary thrombus or thrombotic complication during PCI
  •  Adverse Effects
    • Thrombocytopenia
    • Bleeding