Glycoprotein IIb/IIIa Inhibitors

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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