Tirofiban is a GP IIb/IIIa inhibitor used in the treatment of acute coronary syndrome, including in patients who are to be managed medically and who are undergoing PTCA. It is intended to be used in combination with heparin and aspirin.
Dosage
- Supplied premixed as 500 mL 0.9% NaCl containing 2.5 mg Aggrastat (50 mcg/mL).
- Load: 0.4 mcg/kg/min over 30 minutes.
- Infuse: 0.1 mcg/kg/min through procedure and for 12 to 24 hours after angioplasty or atherectomy.
- Key point:Patients with renal insufficiency (creatinine clearance <30 mL/min) should have the standard infusion rate decreased by 50%.
Table 8.31
Considerations
- Tirofiban and heparin can be administered through the same line.
- Tirofiban may be administered at the Y site with dopamine, famotidine, lidocaine, and potassium chloride.
- May cause bradycardia, thrombocytopenia, and increased risk of bleeding.
- Platelet function recovers within 4 to 8 hours after the drug is discontinued.