756
P A R T 8
Drugs acting on the cardiovascular system
TABLE 48.1
DRUGS IN FOCUS Drugs affecting clot formation and resolution (continued)
Drug name
Dosage/route
Usual indications
Antiplatelet agents (continued)
eptifibatide (Integrilin)
180 mcg/kg IV over 1–2 minutes, then
2 mcg/kg per minute IV for up to 72 hours
for acute coronary syndrome; 135-mcg/kg IV
bolus before procedure, then 0.5 mcg/kg per
minute IV for 20–24 hours
Treatment of acute coronary syndrome;
prevention of ischaemic episodes
in people undergoing percutaneous
coronary interventions
prasugrel (Effient)
Single 60 mg PO loading dose, then 10 mg/day
PO
Prevention of atherothrombotic events
in individuals with acute coronary
syndromes, in conjunction with aspirin
ticagrelor (Brilinta)
180 mg PO loading dose, then 90 mg PO b.d.
Prevention of atherothrombotic events
in individuals with acute coronary
syndromes, in conjunction with aspirin
ticlopidine (Tilodene)
250 mg PO b.d.
Reduction of the risk of thrombotic stroke
in people with TIAs or history of stroke
who are intolerant to aspirin therapy
tirofiban (Aggrastat)
0.4 mcg/kg per minute IV over 30 minutes,
then continuous infusion of 0.1 mcg/kg per
minute
Treatment of acute coronary syndrome
and prevention of cardiac ischaemic
events during percutaneous coronary
intervention; used in combination with
heparin
Anticoagulants
antithrombin III
(Thrombotrol-VF)
Dose must be calculated using body weight
and baseline levels, given every 2–8 days
Replacement in hereditary antithrombin III
deficiency; treatment of people with this
deficiency who are to undergo surgery
or obstetrical procedures that might put
them at risk for thromboembolism
apixaban (Eliquis)
2.5–5 mg PO b.d.
Prevention of thromboembolic events in
individuals who have undergone elective
total hip or total knee replacement;
prevention of stroke and embolism in
individuals with atrial fibrillation and one
or more risk factors
bivalirudin (Angiomax)
1-mg/kg IV bolus, then 2.5 mg/kg per hour IV
for 4 hours and 0.2 mg/kg per hour IV as a
low-dose infusion
Prevention of ischaemic events in people
undergoing transluminal coronary
angioplasty when used in combination
with aspirin
dabigatran (Pradaxa)
220 mg PO once daily
Prevention of thromboembolic events in
individuals who have undergone elective
total hip or total knee replacement;
prevention of stroke and embolism in
individuals with atrial fibrillation and one
or more risk factors
fondaparinux (Arixtra)
Prevention: 2.5 mg/day by SC injection
starting 6–8 hours after surgical closure and
continuing for 5–9 days
Treatment: 5–10 mg/day by SC injections for
5–9 days
Prevention and treatment of venous
thromboembolic events following surgery
for hip fracture, hip replacement or knee
replacement; used with warfarin when
appropriate
heparin (generic)
10,000–20,000 units SC, then 8000–10,000
units q 8 hours; 5000–10,000 units IV
q 4–6 hours
Paediatric: 50 units/kg IV bolus, then
100 units/kg IV q 4 hours
Prevention and treatment of venous
thrombosis, pulmonary embolus, atrial
fibrillation with embolisation; prevention
of clotting in blood samples, dialysis and
venous tubing; diagnosis and treatment
of disseminated intravascular coagulation
(DIC) (Box 48.3); also used as an adjunct
in the treatment of MI and stroke
