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Abciximab

Characteristics

Fab-fragment chimera chelovecesco / mouse monoclonal antibody 7E3.

Of drugs

The drugs-antitromboticescoe, antianginalnoe. The conformational changes binding аргинин-глицин-аспара гинат-участка receptor and prevents the release fibrinoguena factor Villebra cb6 nda etc. adgeziveh molecules with activated glikoproteinovm set GPIIb / IIIa on platelets membrane, disrupting the final stage of aggregation Trombozitov.pri in / in a constant concentration abziksimaba plasma supported only on the condition of continuous infusions, but after a fall during the 6900 fast, and then slowly, over a period of 10 days because of the fraction of trombozitami. In / in a bolusnoe leads to the oppression Adf-inducyrovanna aggregation of platelets. After 2 h after high doses blocked more than 80% of receptor GPIIb / IIIa. Average time haemorrhage increased to over 30 minutes. Upon termination Infusion Aggregation normal after 48 hours, the time-bleeding within 24 hours Use transluminalna percutaneous coronary angioplastike reduces mortality, chactotu acute heart attack (average of 35%), the need to re-angioplasticeskih operations, the prosthesis and coronary bypass. The 51% reduction in the risk of dying or of severe heart attacks within six months after installation stenta. The risk of death, heart attack or the need for revascularization within six months decreased from 18.3% in the group stentov placebo to 13.0% in the group and stentov abziksimaba, and in patients with concomitant diabetes in the same groups - from 25.2% to 13.0%. In volatile strokes reduced fatality rate and the frequency of acute myocardial infarction. The combination therapy unstable strokes in combination with geparinom and aspirin improves the clinical course of disease, a positive impact on developments in the defeat of coronary artery (according to the re-koronaroangiografii), improves the flow properties of the blood, particularly in cases refrakternosti to the usual therapy. Increases Frequency bleeding at the site Puncture femur artery and the subsequent aortocoronarnom shuntirovanii at shunt twice. Creates high risk of bleeding.

Indications

Trombofilicescie condition, including acute myocardial infarction with paddle Q within 12 hours after it began, postinfarctnaya stenocardia, unstable stenocardia. The following angioplastiki coronary arteries or ateroektomii to prevent cardialnah acute ischaemic complications in patients with high-risk reoccluzii operirovannogo receptacle (intrakoronarnogo the brain, damage length> 20 mm).

Side-Effects

Bleeding at the puncture artery, internal bleeding (in the blood, urinary ways retroperitonealnah sites vnutricerepnae), aetiology, AV blockade gipotenzia, nausea, vomiting, gipestesia, sputannosti consciousness plevralny vpot, pneumonia, pain, visual impairment, peripheral edema, anemia, leucocytosis, thrombocytopenia, allergic reactions (up to anaphylacticski shock).

Patient interaction

Effect increase combined, and trombolitiki antitrombozitarnae drugs. The combined use with other monoclonal antibodies increase the risk of allergic reactions.

Precautions

It may be used only in the hospital on strict conditions. The drug interaction in the syringe with your 0.2 or 0.22 micron low-linking proteins to reduce the chance of developing trombozitopenia because of the presence of protein impurities. Is not recommended since angioplastiki if the operation in / in the extensive acid. If you have heavy bleeding from the fall BCC and uncontrollable hypotonia, allergic reactions and trombozitopenia cease treatment and handling trombozitarnuu estate. Monitoring koagulyaim potential effected by the time of activated blood clotting at 300-350 with every 15-30 minutes throughout the process angioplastiki. At the same time, record levels of hemoglobin, gematokrit, the number of platelets, PT (trombozitarnoe time) at the start and every 12 h prior to the removal of catheters. In the future, each of these indicators should be measured every day to a period of sustained improvement or discharge from the hospital. Inguinal area to be surveyed twice a day to detect signs of bruises, a new vascular noise, or Krovotechenia.u patients over 70 years of age or weighing less than 75 kg, a more closely monitored for early signs of bleeding or other means of correction hemostasis (increased tendency to serious bleeding).

Dosing and Administration

In / in, bolusno for 10-60 min before coronary angioplastiki - 0.25 mg / kg, then infuzionno a 10 µ g / min for 12 h.

Literature

1. Reopro. Quick Guide. The international scientific and clinical literature on Reopro. Comments and analysis / Red. N. Chronos, N. Uren-88 c.2. Zijlstra F., P. Beukema, van't Hof A.W.J. et al. Randomized comparison of primary coronary angioplasty with thrombolytic therapy in low risk patients with acute myocardial infarction / / J. Am. Coll. Cardiol 1997 .- .- V. 29-N-5 P. 908-912.

See also

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