❤️ ReoPro (Abciximab)Used as an adjunct to percutaneous coronary intervention (PCI) to prevent acute thrombosis. ⚠️ Main risk: major bleeding and thrombocytopenia.

Always check the BNF here for up-to-date prescribing guidance.

🩸 Potent intravenous antiplatelet agent.
🏥 Used mainly in specialist cardiology settings.
💉 Given around the time of PCI (angioplasty/stenting).
⚠️ Requires close monitoring for bleeding and platelet count.

⚙️ Mode of Action

🧬 Monoclonal antibody against platelet Glycoprotein IIb/IIIa receptor.
🚫 Blocks fibrinogen binding → prevents platelet cross-linking.
⛔ Inhibits the final common pathway of platelet aggregation.
⚡ Rapid onset of action.
⏳ Plasma half-life ≈ 30 minutes, but platelet inhibition lasts 12–24 hours.

🧠 Clinical insight: Although plasma levels fall quickly, platelet function remains impaired due to persistent receptor binding.

🎯 Indications

❤️ Percutaneous coronary intervention (angioplasty, stenting).
🚨 High-risk unstable angina or NSTEMI undergoing PCI.
🩺 Selected cases with high thrombotic burden (specialist decision).

💉 Dose (Specialist Use Only)

⚠️ Prescribed only by cardiology specialists. Always verify locally.

Drug	Dose	Frequency	Route
Abciximab	250 mcg/kg over 1 minute	Stat bolus	IV
Abciximab	0.125 mcg/kg/min (max 10 mcg/min)	12-hour infusion	IV

🔄 Drug Interactions

⚠️ Increased bleeding risk with:
- Aspirin
- Clopidogrel / Ticagrelor
- Heparin / LMWH
- DOACs / Warfarin
🧪 Additive effect with thrombolytics.
⏳ Platelet inhibition may persist despite drug clearance.

🚫 Contraindications

⛔ Absolute
- Active internal bleeding.
- Recent haemorrhagic stroke.
- Intracranial tumour, AVM, or aneurysm.
- Severe uncontrolled hypertension.
- Recent major trauma or surgery.
⚠️ Relative
- Hypertensive retinopathy.
- Recent ischaemic stroke.
- Severe liver disease.
- Bleeding diathesis.

⚠️ Side Effects

🩸 Bleeding
- Access site bleeding.
- GI bleeding.
- Intracranial haemorrhage (rare, catastrophic).
📉 Thrombocytopenia
- Acute immune-mediated.
- Can be profound.
📉 Hypotension
🤢 GI: Nausea, vomiting
🌡️ Systemic: Fever, chest pain, pleurisy
🫁 Rare: ARDS, cardiac tamponade

🚨 Platelet count should be checked at baseline, 2–4 hours, and 24 hours after starting therapy.

🧪 Monitoring

🩸 Full blood count (baseline and daily).
📊 Platelet count (early detection of HIT-like reaction).
🧪 Coagulation profile.
❤️ Vital signs and access site checks.
🫀 Monitor for occult bleeding.

🩺 Practical Prescribing & Nursing Tips

📍 Use smallest possible arterial sheath during PCI.
🩹 Apply prolonged pressure to access sites.
🚫 Avoid IM injections and unnecessary venepuncture.
📋 Document start/stop times clearly.
🔍 Investigate any fall in Hb or BP urgently.

📚 References

Summary of Product Characteristics – Abciximab

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Abciximab 💊