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Abciximab - mechanism of action/ indication/ contraindication/ dose

It is a Fab fragment of a humanized monoclonal antibody directed against the glycoprotein IIb/IIIa. The latter is a platelet surface integrin. It is a receptor for fibrinogen which binds platelets to each other causing aggregation.


By inhibiting the receptor, abciximab acts as a potent antiplatelet agent. 

Indications:
1) myocardial ischemia,
2) percutaneous coronary intervention.

Dose:
1) For M.I - initially an I.V bolus of 0.25 mg/kg over 5 min followed by 0.125 µg/kg/min (to a maximum of 10 µg/min) for 12 hours.
2) For P.C.I - initially, 0.25 mg/kg I.V bolus over 5 min 20-60 min prior to angioplasty followed by 0.125 µg/kg/min (to a maximum of 10 µg/min) for next 12 hours.

Contraindications:
1) bleeding disorder or use of anticoagulant within 7 days,
2) CVA within 2 years,
3) known allergy to this product,
4) major trauma or surgery within 6 weeks,
5) severe uncontrolled hypertension,
6) active internal bleeding,
7) thrombocytopenia i.e platelet count < 100,000/ µL.
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