Document Detail


Clinical challenges of platelet glycoprotein IIb/IIIa receptor inhibitor therapy: bleeding, reversal, thrombocytopenia, and retreatment.
MedLine Citation:
PMID:  10650315     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Randomized clinical trials of glycoprotein IIb/IIIa integrin inhibition during percutaneous coronary intervention and as adjunctive treatment of acute coronary syndromes have shown impressive clinical efficacy in reducing the morbidity and mortality rates of cardiovascular disease. Three agents are currently available in the United States: abciximab (ReoPro), eptifibatide (Integrilin), and tirofiban (Aggrastat). Pharmacodynamic studies show that abciximab is a high-affinity agent with a low dissociation constant; eptifibatide and tirofiban are high-specificity agents with higher dissociation constants and concentration-dependent antiplatelet effects. This article first reviews the relevant pharmacokinetic and pharmacodynamic properties of each of the agents. These principles are then applied to a discussion of the 4 primary clinical issues concerning their use: prevention of untoward bleeding, algorithms for acute reversal, recognition and treatment of thrombocytopenia, and the issue of readministration.
Authors:
J E Tcheng
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  American heart journal     Volume:  139     ISSN:  0002-8703     ISO Abbreviation:  Am. Heart J.     Publication Date:  2000 Feb 
Date Detail:
Created Date:  2000-03-03     Completed Date:  2000-03-03     Revised Date:  2006-02-27    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  S38-45     Citation Subset:  AIM; IM    
Affiliation:
Duke Clinical Research Institute, Durham, NC, USA. tchen001@mc.duke.edu
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MeSH Terms
Descriptor/Qualifier:
Hemorrhage / chemically induced*,  mortality,  prevention & control
Humans
Myocardial Ischemia / blood,  drug therapy
Peptides / adverse effects
Platelet Aggregation Inhibitors / adverse effects*
Platelet Glycoprotein GPIIb-IIIa Complex / antagonists & inhibitors*
Recurrence
Risk Factors
Survival Rate
Thrombocytopenia / chemically induced*,  mortality,  prevention & control
Tyrosine / adverse effects,  analogs & derivatives
Chemical
Reg. No./Substance:
0/Peptides; 0/Platelet Aggregation Inhibitors; 0/Platelet Glycoprotein GPIIb-IIIa Complex; 0/eptifibatide; 144494-65-5/tirofiban; 55520-40-6/Tyrosine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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