Abciximab (ReoPro)

Indications

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Pharmacology

  • Platelet Glycoprotein IIb/IIIa Receptor Antagonist (see IIb IIIa Inhibitors, [[IIb IIIa Inhibitors]])

Administration

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Adverse Effects

Hematologic Adverse Effects

  • Pseudothrombocytopenia (see Thrombocytopenia, [[Thrombocytopenia]])
    • Epidemiology
      • In EPIC trial, the incidence of pseudothrombocytopenia with abciximab was 1.1%, whereas the incidence of true acute thrombocytopenia was 2.7% with abciximab
    • Mechanism: platelet clumping due to EDTA in collection tube -> miscounting on automated detectors
      • Platelet clumping has been reported with all 3 agents
    • Diagnosis of Platelet Clumping
      • Collect Blood in Citrate Tubes: may allow accurate counting in some, but not all cases of EDTA-associated clumping
      • Inspection of Smear: gold standard for accurate platelet count
  • Thrombocytopenia (see Thrombocytopenia, [[Thrombocytopenia]])
    • Epidemiology: in EPIC trial, the incidence of pseudothrombocytopenia with abciximab was 1.1%, whereas the incidence of true acute thrombocytopenia was 2.7% with abciximab
    • Mechanism: believed to be due to preformed antibodies against neoepitopes exposed by alteration of the GP IIb/IIIa molecules
    • Clinical: can occur in a matter of hours

Hemorrhagic Adverse Effects Due to Platelet Dysfunction

Other Adverse Effects

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References

  • Diffuse alveolar hemorrhage following administration of tirofiban or abciximab: A nemesis of platelet glycoprotein IIb/iIIa inhibitors. Catheterization and Cardiovascular Interventions Volume 49, Issue 2, pages 181–184, February 2000
  • Alveolar Hemorrhage: An Underdiagnosed Complication of Treatment with Glycoprotein IIb/IIIa Inhibitors. Journal of Interventional Cardiology Volume 19, Issue 4, pages 356–363, August 2006
  • Moll S, Poepping I, Hauck S, et al. Pseudothrombocytopenia after abciximab (Reopro) treatment. Circulation 1999; 100:1460
  • Dasgupta H, Blankenship J, Wood G, et al. Thrombocytopenia complicating treatment with intravenous IIb/IIIa receptor inhibitors: a pooled analysis. Am Heart J 2000; 140:206-211