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ICARnet
Drug Administration Guidelines
USE:
Tirofiban 1
Non ST-elevation Acute Coronary Syndrome:
Anginal pain in previous 12 hours and
ST depression or elevated serum markers
To be used in conjunction with heparin/enoxaparin and aspirin.
PREPARATION:
Withdraw 50mL from a 250mL bag of Glucose 5%.
Replace with 50mL of Tirofiban from vial. Mix well.
Withdraw 50mL into each syringe for use in syringe driver.
Refrigerate unused syringes and discard after 24hrs.
COMPATIBLE FLUIDS:
Glucose 5% , Sodium Chloride 0.9%
COMPATIBILITIES: During Tirofiban infusion, Morphine can be injected via the side arm.
RECOMMENDED ADMINISTRATION OF TIROFIBAN:
Loading infusion: 0.4microgram/kg/minute for 30 minutes, then
Maintenance infusion: 0.1microgram/kg/minute for 48 hours
Weight
kg
Loading Infusion
0.4mcg/kg/min
volume in 1st 30 min
Maintenance Infusion
0.1mcg/kg/min
rate (mL/hr)
(= pump rate mL/hr for 1st 30 min)
30-37
38-45
46-54
55-62
63-70
71-79
80-87
88-95
96-104
105-112
113-120
121-128
129-137
138-145
146-153
8mL over 30 min (pump rate: 16mL/hr)
10mL over 30' (pump rate:20mL/hr)
12mL over 30' (pump rate: 24mL/hr)
14mL over 30' (pump rate: 28mL/hr)
16mL over 30' (pump rate: 32mL/hr)
18mL over 30' (pump rate: 36mL/hr)
20mL over 30' (pump rate: 40mL/hr)
22mL over 30' (pump rate: 44mL/hr)
24mL over 30' (pump rate: 48mL/hr)
26mL over 30' (pump rate: 52mL/hr)
28mL over 30' (pump rate: 56mL/hr)
30mL over 30' (pump rate: 60mL/hr)
32mL over 30' (pump rate: 64mL/hr)
34mL over 30' (pump rate: 68mL/hr)
36mL over 30' (pump rate: 72mL/hr)
then 4mL/hr
5mL/hr
6mL/hr
7mL/hr
8mL/hr
9mL/hr
10mL/hr
11mL/hr
12mL/hr
13mL/hr
14mL/hr
15mL/hr
16mL/hr
17mL/hr
18mL/hr
SPECIAL PRECAUTIONS:
#1. In severe renal insufficiency (Creat clearance <30mL/min),
decrease dose by 50%
creatinine clearance (male)
=
(140-age) x (weight in kg)
815 x serum creat (mmol/L)
creatinine clearance (female) = 0.85 x (140-age) x (weight in kg)
815 x serum creat (mmol/L)
#2.
Monitor platelets, Hb – baseline, at 2 hours, at 6 hours & daily thereafter.
If platelet count <100,000 or drops 25% below baseline platelet count
Stop tirofiban, heparin and aspirin
SIDE EFFECTS:
1.
Bleeding
2.
Thrombocytopenia
Cardiac Clinical Pharmacy Service, F.M.C.
W endy Siebert: IV-Tirofiban2003
07/05/17
ICARnet
Drug Administration Guidelines
Tirofiban 2
PHARMACOLOGY:
Tirofiban, a potent antagonist of platelet glycoprotein IIb/IIIa receptors,
inhibits platelet aggregation.
Platelet aggregation is a critical initiating step in clot formation.
Acute coronary ischaemic syndromes are due to clots forming on disrupted atherosclerotic plaques
and partially or completely occluding coronary arteries.
In patients with unstable angina and non-Q-wave infarction, tirofiban reduces refractory ischaemia
and new myocardial infarction.
OTHER NAMES: Aggrastat
PRESENTATION:
12.5mg per 50mL glass vial FOR DILUTION
COST: $320 ($372.60 PBS) per vial
Cardiac Clinical Pharmacy Service, F.M.C.
W endy Siebert: IV-Tirofiban2003
07/05/17