Tài sản của tĩnh mạch GP IIb / IIIa Antagonists Năm Abciximab Nhà cung cấp thương mại tên của trọng lượng phê duyệt integrin Cơ cấu chọn lọc phân tử (kDa) Plasma một nửa cuộc sống chỉ bài tiết được phê duyệt chấp thuận | 338 Table 19-3 Properties of Intravenous GP IIb IIIa Antagonists Abciximab Eptifibatide Tirofiban Lamifban Commercial name ReoPro Integrilin Aggrastat Supplier Centocor Eli Lilly COR Schering-Plough Merck Roche Year of approval 1995 1998 1998 Structure Antibody Fab fragment Cyclic heptapeptide Synthetic nonpeptide Synthetic nonpeptid Integrin selectivity aIIbp3 and ttvPs aIIbp3 aIIbp3 aIIbp3 Molecular weight kDa 48 Plasma half-life 10-30 min approx h approx 2 h approx 2 h Excretion Unknown approx 50 renal 40-70 renal 90 renal Approved indications PCI Refractory unstable angina if PCI is to be performed within 24 h NSte ACS NSTE ACS Not approved Approved dose PCI Bolus mg kg Infusion pg kg min max 10 pg min ACS PCI within 24 h Same as above for 12-24 h ACS Bolus 180 pg kg Infusion pg kg min X 72-96 h PCI Bolus 135 pg kg Infusion pg kg min X 20-24 h ESPRIT Bolus 2 X 180 pg kg 10 min apart then pg k min X 18-24 h ACS pg kg min X 30 min then pg kg min X 48-108 h Not approved Major clinical trials EPIC EPILOG CAPTURE EPISTENT rApPORT ADMIRAL CADILLAC TARGET GUSTO-IV GUSTO-V PURSUIT IMPACT-II PRISM PRISM-PLUS RESTORE TARGET PARAGON A PARAGON B NSTE non-ST-segment elevation PCI percutaneous coronary intervention ACS acute coronary syndrome. From Cannon CP. Management of Acute Coronary Syndromes 2nd ed. Totowa NJ Humana Press 2003 p. 500. Chapter 19 Antiplatelet Agents 339 tion the occurrence of crosslinking between platelets to form a white thrombus requires the activation of a common final pathway the glycoprotein GP IIb IIIa receptor-mediated linking of one platelet to another by binding to fibrinogen and in high-shear-stress conditions to von Willebrand factor. Given that platelets may be activated by multiple pathways but aggregate through a single pathway the GP IIb IIIa receptor emerged 33 . Ori Ben-Yehuda 34 points out that despite an American College of Cardiology American Heart Association ACC AHA class I indication
