Integrilin

Integrilin is a drug that is used in the treatment of various diseases affecting the cardiovascular system. It is prescribed to prevent the development of myocardial infarction, and also prevent the closure of blood vessels and the subsequent complications of ischemic nature.

Drug substance is an antiplatelet drug. The drug effect it has is based on the activity of the active drug element - the eptifibatide component.

[1]

Indications Integrilina

It is used in the case of staying in the active phase of coronary syndrome (this includes unstable angina and acute stage of myocardial infarction). In addition, it can be prescribed to prevent occlusion of the affected artery with blood clots, as well as complications of the ischemic type, which appear in connection with the PTCA exercise.

The drug can be used in combination with aspirin, as well as heparin unfractionated type.

[2], [3]

Release form

The release of drugs is in the form of a liquid for IV injections. Contained in bottles with a capacity of 100 ml. Inside the package there is also a device with which the vial of medicine is suspended.

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Pharmacodynamics

Slowing platelet aggregation is reversible - platelet activity is half restored after 4 hours after the infusion. The drug does not have a noticeable effect on the level of PTV, as well as the APTT.

Integrilin inhibits platelet aggregation during intravenous use. At the same time, the intensity of this depression depends on the size of the portion used and the indicators of the drug.

[5], [6]

Dosing and administration

Integrilin can be prescribed exclusively for adult patients.

Persons who have no contraindications regarding the use of heparin, can be used in combination with medication.

In addition, the drug is used together with aspirin, because it is an indispensable part of therapy for coronary syndrome in the active phase. Use aspirin can not only those people whom it is contraindicated.

In case of acute coronary syndrome, the medicament is applied by intravenous jet method in a portion of 180 µg / kg. Next, you need to transfer to the introduction through the dropper in a dosage of 1-2 mg / kg per minute (depending on serum creatinine values) within 3 days (or until the end of inpatient therapy).

When there is an urgent need for PTCA, it is necessary to continue the infusion within 18 or 24 hours from the moment of the procedure (treatment should last a maximum of 96 hours). Persons weighing more than 121 kg are prohibited from administering more than 22.6 mg (bolus), as well as 15 or 7.5 mg / hour (infusion). Accordingly, the creatinine values are below 0.18, as well as 0.18-0.36 mmol / l.

Before performing PTCA, it is necessary to inject a bolus of 180 µg / kg of the substance, and then, through continuous infusion, inject another 1-2 µg / kg of drug per minute (depending on the creatinine level).

After 10 minutes from the moment of the 1st bolus, another 180 μg / kg of the drug is injected in the same way. To last such an infusion should be 18-24 hours or until the end of the hospital. The minimum duration of the procedure is 12 hours.

[13], [14], [15]

Use Integrilina during pregnancy

The decision regarding the use of drugs during pregnancy can only be taken by the doctor, taking into account all the risks and benefits of such use for the woman and the fetus.

There is no information about whether eptifibatide penetrates into breast milk. Therefore, at the time of therapy, breastfeeding should be abandoned.

Contraindications

The main contraindications:

• bleeding in the gastrointestinal tract or having a genital or urological nature, as well as other intensive bleeding of a pathological nature, observed in a patient during the last month;
• thrombocytopenia;
• severe intolerance caused by the action of the active element or other components of the drug;
• previously transferred intracranial pathology (tumor, aneurysm or arterial-venous malformation);
• a history of hemorrhagic stroke or acute cerebral blood flow disorder during the last month;
• the PTV indicator is higher than 1.2 from the control level or MHO≥2;
• previously transferred diathesis of hemorrhagic nature;
• clinical severity of liver failure;
• severe injury or extensive surgery over the past 1.5 months;
• a strong increase in blood pressure values during antihypertensive therapy;
• lack of kidney function in severe;
• the planned introduction of another similar drug or combined reception with him;
• need for hemodialysis sessions.

[7], [8], [9]

Side effects Integrilina

Among the side effects are:

• disorders associated with blood and lymph: often there are bleeding (both weak and heavy) in the area behind the peritoneum, in the mouth or oropharynx, in the gastrointestinal tract, inside the skull or urogenital, and hematuria). Sometimes thrombocytopenia develops;
• lesions affecting the heart: often marked CHF, ventricular tachycardia, ventricular fibrillation, cardiac arrest, AV blockade, and atrial fibrillation;
• disorders in NA: sometimes cerebral ischemia occurs;
• problems with vascular function: lower blood pressure, phlebitis, or cardiogenic shock.

 Information obtained during post-registration studies:

• lymph and blood lesions: single hematomas, various bleeding in the lung area, a deep form of thrombocytopenia in the active phase and bleeding with a fatal outcome;
• infections of the subcutaneous layers and the epidermis: rashes and negative symptoms develop in the area of the injection site (urticaria);
• immune disorders: anaphylactic manifestations occur sporadically.

[10], [11], [12]

Overdose

There is only limited information regarding Integrilin intoxication. It is assumed that with the introduction of high portions of the drug may appear bleeding.

It is possible to weaken the effect of the drug by canceling the infusion. In addition, the medicinal substance is excreted through hemodialysis. Sometimes the patient may need blood transfusion.

[16], [17], [18]

Interactions with other drugs

It is forbidden to combine Integrilin and furosemide.

With caution, the drug is used together with drugs that affect hemostasis: among them adenosine, NSAIDs, dextran, drugs containing prostacyclin, and in addition, anticoagulants for ingestion and thrombolytics.

Combining drugs with streptokinase (introduced during the treatment of the acute stage of myocardial infarction) increases the likelihood of bleeding.

The simultaneous use of drugs with heparin is allowed only in the absence of any contraindications to the introduction of the latter (for example, thrombocytopenia in history, developed due to the use of heparin).

Extreme caution should be combined medication with a low molecular weight heparin.

[19], [20], [21]

Storage conditions

Integrilin must be kept in a dark place, closed from small children. Temperature indicators - in the range of 2-8 ° C.

[22], [23], [24], [25], [26]

Shelf life

Integrilin can be used for a 36-month term from the time the drug was manufactured.

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Application for children

It is forbidden to use Intergrilin in pediatrics.

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Analogs

Analogue of drugs is a tool Eptifibatid.

[30], [31], [32], [33], [34], [35]

Reviews

Integrilin receives good reviews from patients and doctors. Doctors indicate that the drug works well in the treatment or prevention of certain diseases affecting the cardiovascular system. Patients secrete a high rate of drug exposure and its effectiveness.

[36], [37], [38], [39],