Glycoprotein IIb/IIIa inhibitors

Include abciximab, eptifibatide (Integrillin), and tirofiban.

Glycoprotein IIb/IIIa inhibitors, also GpIIb/IIIa inhibitors, is a class of antiplatelet agents.

Several GpIIb/IIIa inhibitors exist:

abciximab (ReoPro)

eptifibatide (Integrilin)

tirofiban (Aggrastat)



Frequently used during percutaneous coronary intervention.

They work by preventing platelet aggregation and thrombus formation.

They inhibit the GpIIb/IIIa receptor on the surface of the platelets.

They may also be used to treat acute coronary syndromes, without percutaneous coronary intervention, depending on risk.

They should be given intravenously.

The oral form is associated with increased mortality and hence should not be given.

Should be considered for use in all patients with percutaneous coronary interventions.

Should be considered in all patients with unstable angina who have elevated troponin levels.

30-40% reduction in death or myocardial infarction.

Most common adverse effect is bleeding, most commonly at vascular access sites.

After percutaneous coronary intervention significantly lowers 30-day mortality, reduces nonfatal myocardial infarction and preserves the reduced mortality at 6 months.

Beneficial effect observed within 24 hours of coronary intervention.

Abrupt onset of severe thrombocytopenia occurs in about 0.5-1% of patients receiving such agents the first time and the reaction is immune mediated.

Increase the risk of hemorrhagic complications and thrombocytopenia, which are strongly associated with early and late mortality after PCI.

Eptifibatide (Integrilin), a platelet glycoprotein IIb/IIIa inhibitor, is renally cleared and its use is contraindicated with dialysis because of increased bleeding risk.

Unfractionated heparin, low molecular weight heparins, and fondaparinux activate platelets by binding to the platelet glycoprotein IIb/IIIa integrin receptor.

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