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Acute Coronary Syndromes: A Focus on STEMI10 Topics3 Quizzes
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Acute decompensated heart failure10 Topics3 Quizzes
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Hypertensive Urgency and Emergency Management11 Topics3 Quizzes
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Acute aortic dissection8 Topics2 Quizzes
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Supraventricular Arrhythmias (Afib, AVNRT)10 Topics2 Quizzes
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Ventricular Arrhythmias10 Topics2 Quizzes
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Tirofiban
Eptifibatide
- Mechanism of action:
- GP IIb/IIIa Receptor Antagonists
- Dosage:
- (double bolus): 180-mcg/kg IV bolus, then 2 mcg/kg/min; a second 180-mcg/kg bolus is administered 10 min after the first bolus
- In patients with CrCl <50 mL/min, reduce infusion by 50%
- Avoid in patients on hemodialysis
- PK:
- Onset of action: Within 1 minutes of bolus administration
- Elimination half-life: 2.5 hours
- Adverse Effects:
- Dyspnea, hypotension, headache, bleeding
- Clinical Pearls & Practical Considerations:
- It should be discontinued at least 2 hours prior to surgery or other invasive procedures.
AHA STEMI Guidelines- GP IIb/IIIa Receptor Antagonists Prior to PCI
| Drug | Recommendation | LOE | COE |
| Abciximab | 0.25-mg/kg IV bolus, then 0.125 mcg/kg/min (maximum 10 mcg/min) (No longer on the market in the US) | IIa | A |
| Tirofiban | (high-bolus dose): 25-mcg/kg IV bolus, then 0.15 mcg/kg/min ● In patients with CrCl <30 mL/min, reduce infusion by 50% | IIa | B |
| Eptifibatide | (double bolus): 180-mcg/kg IV bolus, then 2 mcg/kg/min; a second 180-mcg/kg bolus is administered 10 min after the first bolus •In patients with CrCl <50 mL/min, reduce infusion by 50% •Avoid in patients on hemodialysis | IIa | B |
| Pre-catheterization laboratory administration of IV GP IIb/IIIa receptor antagonist | IIb | B | |
| Intracoronary abciximab 0.25-mg/kg bolus (No longer on the market in the US) | IIb | B |
2013 ACCF/AHA guideline. Circulation. 2013 Jan 29;127(4):e362-425.