Which medications in the drug class Glycoprotein IIB/IIIA inhibitors are used in the treatment of Acute Coronary Syndrome?

Updated: Sep 30, 2020
  • Author: David L Coven, MD, PhD; Chief Editor: Eric H Yang, MD  more...
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Answer

Glycoprotein IIB/IIIA inhibitors

Glycoprotein IIb/IIIa receptor antagonists include abciximab, eptifibatide, and tirofiban. Glycoprotein IIb/IIIa antagonists prevent the binding of fibrinogen, thereby blocking platelet aggregation. These drugs inhibit the glycoprotein IIb/IIIa receptor, which is involved in the final common pathway for platelet adhesion and aggregation. Currently, GP IIb/IIIb receptor antagonists in combination with aspirin are considered standard antiplatelet therapy for patients at high risk for unstable angina.

Abciximab (ReoPro)

Abciximab (ReoPro) is a chimeric human-murine monoclonal antibody. It binds to receptors with high affinity and reduces platelet aggregation by 80%. Inhibition of platelet aggregation persists for up to 48 hours after the end of infusion. Abciximab has been approved for use in elective/urgent/emergent percutaneous coronary intervention.

Eptifibatide (Integrilin)

Eptifibatide (Integrilin) is an antagonist of the platelet GP IIb/IIIa receptor; it reversibly prevents von Willebrand factor, fibrinogen, and other adhesion ligands from binding to the GP IIb/IIIa receptor. The end effect is the inhibition of platelet aggregation. The effects persist over the duration of maintenance infusion and are reversed when infusion ends. Use eptifibatide (or tirofiban, see below) in patients with high-risk features in whom invasive treatment is not planned.

Tirofiban (Aggrastat)

Tirofiban (Aggrastat) is a nonpeptide antagonist of the GP IIb/IIIa receptor. It is a reversible antagonist of fibrinogen binding. When administered intravenously, more than 90% of platelet aggregation is inhibited. Tirofiban has been approved to reduce the rate of thrombotic cardiovascular events (combined endpoint of death, myocardial infarction, or refractory ischemia/repeat cardiac procedure) in patients with non-ST elevation acute coronary syndrome (NSTE-ACS).


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