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Eptifibatide-associated acute, profound thrombocytopenia
James C Coons1, Robert A Barcelona, Tucker Freedy
1Cardiology, Department of Pharmacy, Allegheny General Hospital, Pittsburgh, PA 15212-4772, USA. jccst25@hotmail.com
The Annals of Pharmacotherapy
|January 13, 2005
Summary
Eptifibatide, a glycoprotein IIb/IIIa inhibitor, can cause acute, profound thrombocytopenia, a dangerous drop in platelet count. Vigilant monitoring and alternative strategies are crucial for patient safety during treatment.
Area of Science:
- Cardiology
- Pharmacology
- Hematology
Background:
- Glycoprotein IIb/IIIa inhibitors like eptifibatide are used in percutaneous coronary intervention (PCI).
- Acute, profound thrombocytopenia is a rare but serious adverse drug event associated with these inhibitors.
Observation:
- Three cases of eptifibatide-associated acute, profound thrombocytopenia are described.
- Patients experienced a precipitous decline in platelet count (<20 x10(3)/mm3) within 24 hours of eptifibatide initiation.
- Adverse events included hematoma, petechiae, shock, and hypotension.
Findings:
- The causality assessment indicated that the adverse drug event was probable in two cases and possible in one.
- Platelet counts dropped dramatically, necessitating platelet transfusions and discontinuation of eptifibatide.
Implications:
- The increasing use of glycoprotein IIb/IIIa inhibitors necessitates enhanced recognition of this rare complication.
- Vigilant platelet count monitoring is essential during eptifibatide therapy.
- Alternative management strategies should be considered for patients at risk.