Abciximab

Abciximab Glycoprotein llb/llla antibody Coronary angioplasty... 

The data for the use of GP Ilb/Illa inhibitors in conjunction with lAT are even more scant, and are limited to case reports. Intravenous abciximab has been successfully used as adjunctive therapy to lA rt-PA or UK in cases of acute stroke. Desh-mukh et al. reported on 21 patients with large vessel occlusion refractory to lAT with rt-PA who were treated with IV and/or lA abciximab, eptifibatide, or tirofiban. Twelve patients also received IV rt-PA and 18 patients underwent balloon angioplasty. Complete or partial recanalization was achieved in 17 of 21 patients. Three patients (14%) had asymptomatic ICH, but there were no cases of symptomatic ICH. Mangiafico et al. described 21 stroke patients treated with an intravenous bolus of tirofiban and heparin followed by lA urokinase. Nineteen of these patients also underwent balloon angioplasty. TIMI 2-3 flow was achieved in 17 of 21 patients. ICH occurred in 5 of 21 patients (3 symptomatic ICH and 2 SAH), and was fatal in 3... 

Abciximab in acute ischemic stroke a randomized, double-blind, placebo-controlled, dose-escalation study. The Abciximab in Ischemic Stroke Investigators. Stroke 2000 31 601-609. 

Eckert B, Koch C, Thomalla G, Roether J, Zeumer H. Acute basilar artery occlusion treated with combined intravenous Abciximab and intra-arterial tissue plasminogen activator report of 3 cases. Stroke 2002 33 1424-1427. 

Lee DH, Jo KD, Kim HG, Choi SJ, Jung SM, R)oi DS, Park MS. Local intraarterial urokinase thrombolysis of acute ischemic stroke with or without intravenous abciximab a pilot study. J Vase Interv Radiol 2002 13 769-774. 

Qureshi Al, Harris-Lane P, Kirmani IF, Janjua N, Divani AA, Mohammad YM, Suarez Jl, Montgomery MO. Intra-arterial reteplase and intravenous abciximab in patients with acute ischemic stroke an open-label, dose-ranging, phase I study. Neurosurgery 2006 59 789-796 [discussion 796-787]. 

The abciximab in Acute Ischemic Stroke trial was a randomized, placebo-controlled dose-escalation study to examine the safety of abciximab in acute stroke. It randomized 74 patients within 24 hours of stroke onset to receive one of four doses of abciximab (by bolus with or without additional infusion, 54 patients) or placebo (20 patients). The median baseline National Institute of Health Stroke Scale (NIHSS) score was 15. The rates of asymptomatic ICH were 19% in the intervention group compared to 5% in the placebo group p = 0.07). Most (9 of 11) of the asymptomatic ICH patients had more severe stroke (NIHSS >14). No cases of symptomatic ICH or major systemic bleeding occurred. There was a trend toward a lower rate of stroke recurrence (2% vs. 5%) and a higher rate of functional recovery at 3 months in the group treated with abciximab than with placebo. 

In 2004, the abciximab and rt-PA in Acute Ischemic Stroke Treatment trial treated hve patients with abciximab and half dose of rt-PA within 3 hours of symptom onset. The primary aim was to examine the frequency of SICH at 24 hours. This occurred in one of the five patients. The median NIHSS improvement was 6. 

Abciximab Emergent Stroke Treatment Trial Investigators. Emergency administration of abciximab for treatment of patients with acute ischemic stroke results of a randomized phase 2 trial. Stroke 2005 36 880-890. 

Stroke Trials Registry. Abciximab in Emergent Stroke Treatment Trial - 11. www. strokecenter.org/trials. Accessed on July 15, 2007. 

Abciximab and rt-PA in acute ischemic stroke treatment. Presented at the 28th International Stroke Conference February 2003. Acad Emerg Med 2003 10(12) 1396-1399. 

Abciximab, aminophylline, amiodarone, amrinone, aspirin, carbamazepine, chlorpromazine, danazol, diltiazem, eptifi-batide, heparin, histamine2-receptor antagonists, low molecular weight heparins, methyldopa, milrinone, procainamide, quinidine, quinine, NSAIDs, thiazide diuretics, ticlopidine, tirofiban, and valproic acid... 

Abciximab is a first-line glycoprotein Ilb/IIIa receptor inhibitor for patients undergoing primary PCI3,15,18 who have not received fibrinolytics. It should not be administered for... 

In patients with NSTE ACS scheduled for early PCI, administration of either abciximab or eptifibatide (double bolus) is recommended. The use of tirofiban in these patients is not recommended, because it has been shown to be inferior to abciximab.2 Medical therapy with glycoprotein Ilb/IIIa receptor inhibitors in patients not undergoing PCI is reserved for higher-risk patients, such as those with positive troponin or ST-segment depression, and patients who have continued or recurrent ischemia despite other antithrombotic therapy.2... 

Doses and contraindications to glycoprotein Ilb/IIIa receptor blockers are described in Table 5-2. Major bleeding and rates of transfusion are increased with administration of a glycoprotein Ilb/IIIa receptor inhibitor in combination with aspirin and an anticoagulant,30 but there is no increased risk of intracranial hemorrhage in the absence of concomitant fibrinolytic treatment. The risk of thrombocytopenia with tirofiban and eptifibatide appears lower than that with abciximab. Bleeding risks appear similar between agents. 

Abciximab 0.25 mg/kg IV bolus followed by 0.125 mcg/kg/ minute (maximum 10 mcg/minute) for 12 hours Not recom- mended None... 

ReoPro Abciximab Centocor Prevention of blood clots, unstable angina... 

ReoPro (Abciximab, Fab fragments derived from a chimaeric Mab, directed against the platelet surface receptor GPIIb/IIIa)... 

Abciximab is preferred over eptifibatide and tirofiban in this setting because it is the most widely studied agent in primary PCI trials. 

Abciximab, in combination with aspirin, a thienopyridine, and UFH (administered as an infusion for the duration of the procedure), reduces mortality and reinfarction without increasing the risk of major bleeding. 

Administration of either abciximab or eptifibatide is recommended for NSTE ACS patients undergoing PCI. 

Abbreviated New Animal Drug Applications (ANADAs), 21 579 Abbreviated New Drug Application (ANDA) process, 21 575 Abbreviations, l xvii—xxiv 2-26 xv-xxii ABCD fiber categorizing system, 9 199 Abciximab, 4 104t 5 173... 

ReoPro Abciximab Gentocor, a division of Johnson Johnson New Brunswick, NJ Anti-IIb/IIIa Angioplasty 1994... 

Q54 Baseline prothrombin time should be measured in patients receiving abciximab. Abciximab is an antiplatelet agent that acts by increasing the binding of fibrinogen to receptors on platelets. 

Abciximab Platelet gp Ischaemic complica- Platelet aggregation All patients [90]... 

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