Cardiovascular – Renal Drugs : Antiplatelets and Thrombolytics
IAGGR1 “Aggrastat injection” 0.25 mg/ml;50 ml/vial
[泡法]
1amp in N/S or G5W 200ml 0.4mcg/kg/min for 30mins then 0.1mcg/kg/min
[備註]
有下列臨床症狀者應禁用：進行性出血、曾有顱內出血、顱內腫瘤、動靜脈血管畸形或動脈瘤者、先前曾注射aggrastat而引發血小板減少症者
適應症：Aggrastat併用heparin，可用於預防不穩定心絞痛病人或非Ｑ波之心肌梗塞病人發生缺血性心臟病發作，及用於預防患有冠狀動脈缺血症狀而須接受冠狀動脈成形術或冠狀動脈粥狀硬化切除的病人發生治療冠狀動脈突然閉塞時所造成的缺血性心臟併發症。
Usual dose:
Acute coronary syndrome:
Adult: 0.4 mcg/kg/min IV for 30 min then 0.1 mcg/kg/min for 12-24 h after angioplasty/atherectomy.
Dose adjustment:
Renal impairment: severe renal impairment (SCr < 30 ml/min): give half the usual dose- 0.2 mcg/kg/min IV for 30 min then 0.05 mcg/kg/min.
Contraindication:
Aortic dissection bleeding, major surgery, trauma, stroke within 30 days, concomitant use of another parenteral GPIIb/IIIa inhibitor, hemorrhagic stroke, history of intracranial hemorrhage, neoplasm, arteriovenous malformation, or aneurysm, pericarditis, severe hypertension (systolic BP >180 mmHg and/or diastolic BP >110 mmHg), thrombocytopenia.
Adverse effect:
Common: minor bleeding, bradycardia, dizziness.
Serious: major bleeding, coronary artery dissection, thrombocytopenia.
健保使用規範：（91/2/1、99/10/1、100/7/1）
1.限不穩定型心絞痛，對傳統療法無反應者，已預定施行經冠狀動脈成形術之不穩定狹心症時，作為heparin的輔助療法，或非Q波之心肌梗塞之病患使用。
2.急性Q波心肌梗塞於症狀發生十二小時內，於執行PTCA時得併用tirofiban。