GPIIb/IIIa Inhibitors (Abciximab, Tirofiban, Eptifibatide)

Summary

Glycoprotein IIb/IIIa inhibitors, or GPIIb/IIIa inhibitors for short, include the drugs abciximab, tirofiban, and eptifibatide. These drugs work as antiplatelet agents, preventing platelets from functioning to aggregate and form clots. This is useful in preventing blood clots from forming during coronary artery stenting and for treating acute coronary syndromes like myocardial infarction or unstable angina. However, the prevention of blood clots can also cause the side effect of bleeding. Keep a close eye on the patient’s CBC levels and report any signs or symptoms of bleeding to the provider.

Key Points

• Drug Names
  • Abciximab
  • Tirofiban
  • Eptifibatide
  • Mechanism
    • Antiplatelet
      • Block the binding of fibrinogen to the platelet
      • Antiplatelet effects of abciximab last up to 10 days after the infusion. Effects of tirofiban and eptifibatide last up to 4 hours after the infusion.
  • Clinical Use
    • Prevent clot formation
      • During percutaneous coronary intervention (PCI), a procedure where a catheter is inserted to open an occluded coronary artery
      • During acute coronary conditions like unstable angina and acute myocardial infarction
  • Side Effects and Adverse Reactions
    • Bleeding
      • Due to thrombocytopenia (low platelet count)
      • The nurse should be acutely aware of signs of internal bleeding, like hypotension, tachycardia, blood in stools or urine, change in heart rhythm, abdominal/back pain, and change in mental status.
      • Avoid any unnecessary invasive procedures, including needle sticks (IV insertion, IM injections, etc.)
      • Closely monitor CBC levels