The following are indications and contraindications for glycoprotein IIb/IIIa inhibitors:
1. For the treatment of patients with acute coronary syndrome (Unstable Angina with Non-Q- Wave Myocardial Infarction) with chest pain more than 10 minutes in duration within 24 hours of presentation, with at least one of the following findings:
• Electrocardiogram changes showing: ST depression >0.5 mm, ST elevation between 0.6 mm and 1 mm, or T-wave inversion > 1.0 mm.
• Elevated cardiac enzymes, isoenzyme of creatine kinase with muscle and brain subunits, or troponin.
2. Patients undergoing percutaneous coronary intervention.
1. A history of bleeding diathesis, or active abnormal bleeding within the previous 30 days.
2. Uncontrolled severe hypertension: systolic > 200 mm/hg, or diastolic > 110 mm/hg.
3. Major surgery within six weeks.
4. History of stroke within 30 days, or any history of hemorrhagic stroke.
5. Platelet count < 100,000.
6. Dependence on renal dialysis.
7. For patients with a serum creatinine > 2, the dosage should be reduced per prescribing recommendations.
8. Assess patient for warfarin and/or excessive nonsteroidal anti-inflammatory drug usage.
Source: St. Jude Medical Center, Fullerton, CA.