abciximab
Summary
Abciximab is a glycoprotein IIb/IIIa receptor antagonist that prevents platelet aggregation by blocking fibrinogen binding. It's used during percutaneous coronary interventions (PCI) to reduce thrombotic complications. Major side effect is bleeding due to irreversible platelet inhibition.
Detail
Abciximab is a chimeric monoclonal antibody fragment (Fab) that irreversibly binds to the glycoprotein IIb/IIIa receptor on platelets, which is the final common pathway for platelet aggregation. By blocking this receptor, it prevents fibrinogen and von Willebrand factor from cross-linking platelets, effectively inhibiting clot formation. It has a short plasma half-life (10-30 minutes) but prolonged platelet-bound half-life due to irreversible binding, causing platelet dysfunction for 24-48 hours. Clinically used as adjunctive therapy during high-risk PCI procedures, particularly in patients with acute coronary syndromes or complex lesions. The drug significantly reduces ischemic complications but increases bleeding risk, especially when combined with other anticoagulants. Contraindicated in patients with active bleeding, recent surgery, or severe hypertension. Thrombocytopenia can occur due to antibody formation against the drug-platelet complex.
Sources
- Katzung's Basic & Clinical Pharmacology
- Goodman & Gilman's Pharmacological Basis of Therapeutics
- First Aid for the USMLE Step 1
- UpToDate Clinical Database
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