Each singledose vial contains 2 mgml of abciximab in a buffered solution ph 7. Abciximab or abcixifiban previously known as c7e3 fab, a glycoprotein iibiiia receptor antagonist manufactured by janssen biologics bv and distributed by eli lilly under the trade name reopro, is a platelet aggregation inhibitor mainly used during and after coronary artery procedures like angioplasty to prevent platelets from sticking together and causing thrombus formation within the. Uconn health john dempsey hospital 1 bivalirudin angiomax dosing table bivalirudin is a direct thrombin inhibitor, and it is indicated for use as an anticoagulant in patients undergoing percutaneous coronary intervention pci. Munar, pharmd, bcps, and harleen singh, pharmd oregon state university college of pharmacy, portland, oregon.
Abciximab, reopro, is the fab fragment of the chimeric humanmurine monoclonal antibody 7e3. Renal pharmacotherapy is a comprehensive listing of dosage recommendations for patients with compromised renal function. Renal dosing use in patients with renal or hepatic impairment. Pediatric drugs analgesics antihypertensive and cardiovascular agents antimicrobial agents miscellaneous agents sedatives, hypnotics, and other drugs used in psychiatry.
Usual dose q24h esrd crcl renal function helps select a starting dose for treatment. The mean antixa level in the moderate renal impairment group after a dose adjustment was 0. Drug dosing adjustments in patients with chronic kidney disease myrna y. Aug 19, 2019 reopro abciximab for intravenous administration. Continuous renal replacement therapy crrt is a dialysis mode common in icus, for its use in patients with severe hemodynamic instability. Perhaps a consideration for future editions might be to include some general comments on the use of various drug classes in patients with renal disease. They should not replace clinical judgment and are intended to provide initial guidance, and may be modified depending on individual patient. Have pharmacists determine all doses for renal patients. Adult drugs analgesics antihypertensive and cardiovascular agents antimicrobial agents miscellaneous agents sedatives, hypnotics, and other drugs used in. Dosing is adjusted for patients with renal insufficiency, and a quick.
Dowling chronic kidney disease ckd is a progressive consequence of systemic diseases such as diabetes and hypertension as well as localized kidney injury as the result of glomerulonephritis. Drug prescribing in renal failure, 5th edition acp books. Since metoclopramide is excreted principally through the kidneys, in those patients whose creatinine clearance is below 40 mlmin, therapy should be initiated at approximately onehalf the recommended dosage. Abciximab or abcixifiban a glycoprotein iibiiia receptor antagonist manufactured by janssen. Luke probst, a pediatric pharmacy specialist and a clinical assistant professor in the departments of pediatrics and medicine at the state. Learn about the reported side effects, related class drugs, and how these medications will affect your daily lifestyle. Abciximab binds to the glycoprotein gp iibiiia receptor of human platelets and inhibits platelet aggregation. For patients treated with crrt, it is important to understand the factors that determine drug removal to permit optimal drug dosing 2.
It also saves pharmacists time, since they can adjust doses themselves according to the most current clinical needs without waiting to hear from physicians. The dosing regimens are designed to provide simplicity of administration. Reopro solution for injection 2mg drug medication dosage. The data base for rational guidelines to safe, efficacious drug prescribing in adults with renal insufficiency are. Reopro reduces the chance that a harmful clot will. Drug dosing adjustments in patients with chronic kidney. No dosage adjustment provided by manufacturer unstable angina or nsetmi not responding to standard medical therapy and who are planning to get pci within 24 hours.
Reopro is used to lessen the chance of heart attack in people who need percutaneous coronary intervention pci, a procedure to open blocked arteries of the heart. Each single use vial contains 2 mgml of abciximab in a buffered solution ph 7. Mar 09, 2020 reopro is used to lessen the chance of heart attack in people who need percutaneous coronary intervention pci, a procedure to open blocked arteries of the heart. Renal dosage adjustment guidelines for antimicrobials the pharmacists will automatically adjust the doses of any of the antimicrobials included in the protocol according to the estimated creatinine clearance generally using the cockroftgault equation for patients.
If last enoxaparin was given 812 hr before balloon inflation, an iv bolus of 0. For example, the nsaid renal dosing threshold for the pharmacistbased system was ecrcl book is available from the british library. Three gpras are currently available for use in the united states. This uptodate and evidencebased reference closes several identified knowledge gaps concerning medications eliminated by the kidneys. Despite being contraindicated in dialysis, eptifibatide was used. The renal drug handbook the st georges hospital, adult critical. The comparative safety of abciximab versus eptifibatide in patients. Furthermore, where practical the dosing interval was lengthened instead of utilizing a smaller dose in order to decrease the total number of doses. No adjustments for abnormal renal function are required 2.
Perhaps a consideration for future editions might be to include some general comments on the use of. A universallytrusted resource, this fourth edition of the renal drug handbook contains over 800 drug monographs comprising prescribing information. Renal dosage adjustment guidelines for antimicrobials. Marquette general pharmacy dlp renal dosing protocol. Renal functionbased dose adjustments adult inpatient. The mean antixa level in the severe renal impairment group after a dose adjustment was 0. Dosage does not require modification for patients with renal failure. Golper, mo, joseph pulliam, mo, marsha wolfson, mo, and irwin singer, mo. Continuous renal replacement therapy crrt is occasionally required for critically ill patients with acute kidney injury aki 1. A process for assigning all renal patients medication dosing to a pharmacist leaves prescribers more time for other clinical activities and may decrease the risk of adverse drug events. This diminishes the possibility of administration errors by eliminating difficult dosing regimens e.
Note if the clinical status and lab values are trending worse or trending better, to help predict what dose will be appropriate in the coming hours, days or weeks. Aug 15, 2019 reopro is a clear, colorless, sterile, nonpyrogenic solution for intravenous iv use. Dosing of antimicrobial agents in renal insufficiency. Dosing guidelines book dosing guidelines for children dosing guidelines for adults. Mild creatinine clearance 5080 mlmin or moderate creatinine clearance 3050 mlmin. Similarly, in the assent3 study, combination therapy with half dose tenecteplase 1530 mg iv bolus depending on weight, abciximab 0. Easytoread tables put the information physicians need when determining dosages for more than 450 drugs at their fingertips. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. Analgesics antihypertensive and cardiovascular agents antimicrobial agents miscellaneous agents sedatives, hypnotics, and other drugs used in psychiatry. Intravenous administration of abciximab in doses ranging from 0.
The level of renal function below which the dose of a drug must be reduced depends largely on the extent of renal metabolism and elimination, and on the drugs toxicity. This book is distributed under the terms of the creative commons. These dosing recommendations are based on published literature and clinical experiences. Find patient medical information for prorenal qd oral on webmd including its uses, side effects and safety, interactions, pictures, warnings and user ratings.
Dose adjustments are typically made based on stages of ckd, with gfr 90, 6089, 3059, 1529, crrt, we must understand the process of solute removal by diffusion and convection. Aug 15, 2019 the safety and efficacy of abciximab have only been investigated with concomitant administration of heparin and aspirin as described in clinical studies in patients with failed pcis, the continuous infusion of abciximab should be stopped because there is no evidence for abciximab efficacy in that setting. Dosing guidelines book school of medicine university of. Data sources include ibm watson micromedex updated 10 apr 2020, cerner multum updated 6 apr 2020, wolters kluwer updated. Reopro abciximab dose, indications, adverse effects. The recommended dosage of abciximab in adults is a 0. Abciximab does not require dose adjustments for patients with kidney failure.
For new or worsening grade 2 or 3 neuropathy, dosing should be. The reopro and primary ptca organization and randomized trial rapport examined the role of abciximab compared with placebo on a background of aspirin and heparin therapy during balloon angioplasty for stelevation myocardial infarction n483 patients. Estimates of renal function can also be helpful in interpreting drug concentrations e. Hmc uwmc adult antimicrobial renal dosing guidelines. Researchers have studied abciximab in threephase iii clinical trials.
Glycoprotein iibiiia inhibitors in patients with renal. The renal drug handbook is now available in database format. Subsequent dosing should be guided by measured drug concentrations and clinical response. One limitation is that the handbook is a uk publication so some of the drugs and dosing recommendations are not relevant to the australian situation. Not to exceed 75 mgdose for first 2 doses only, followed by 0. A heart attack may occur when a blood vessel in the heart is blocked by a blood clot. Tirofiban and eptifibatide are renally cleared and thus must have dosage adjustment if used in patients with renal insufficiency ri. The pharmacists will automatically adjust the doses of any of the antimicrobials included in the protocol according to the estimated creatinine clearance generally using the cockroftgault equation for patients. While the advice and information in this book are believed to be true and accurate at the date of publication, neither. Data sources include ibm watson micromedex updated 10 apr 2020, cerner multum updated 6 apr 2020. If an infusion reaction occurs, interrupt the infusion. Policy 33643100 renal dosing adjustments page 6 drug standard dosing adjustment in renal impairment adjustment in dialysis ampicillin po 24 500 mg q6h crcl 30 standard dose gi, gu, uri.
Access monograph information through desktop, laptop or mobile devices, with this new, easytouse, frequentlyupdated online platform. Drug dosing adjustments in patients with chronic kidney disease. Grade 4 peripheral neuropathy, adcetris should be discontinued. Reopro solution for injection 2mg drug medication dosage information. Lovenox enoxaparin dosing, indications, interactions. Unstable angina or nsetmi not responding to standard medical therapy and who. Marquette general pharmacy dlp renal dosing protocol drug usual dose crcl adjusted mlmin dose hemodialysis peritoneal dialysis comments acyclovir iv 5 20 mgkg q 8h 25 50 100% of dose q12 h manufacturer suggest 1 l of fluid per gram of drug urine output should be maintained at. Diffusion is the process by which molecules that are present in a solvent and can pass freely across a semipermeable membrane tend to move from the region of higher concentration into the region of. Reopro, abciximab dosing, indications, interactions.
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