Overview of platelet glycoprotein IIb IIIa receptor antagonist treatment in the management of coronary interventions and acute ischemic coronary syndromes

This exercise is intended for primary care physicians, cardiologists, and t hose individuals concerned with formulary decisions. GOAL To provide a review of the pathogenesis of acute ischemic coronary syndrome , as well as an understanding of the role of glycoprotein IIb/IIIa inhibito rs in the management of acute ischemic coronary syndrome. OBJECTIVES 1. Describe the role of platelets in the pathogenesis of acute ischemic cor onary syndrome. 2. Compare the clinical pharmacology, pharmacokinetics, and therapeutic ind ications of the 3 glycoprotein IIb/IIIa inhibitors currently available on t he U.S. market (abciximab, eptifibatide, and tirofiban). 3. Discuss published clinical trials on glycoprotein IIb/IIIa inhibitors in the management of acute ischemic coronary syndromes. 4. Describe the cost and cost effectiveness of using glycoprotein IIb/IIIa in the management of acute ischemic coronary syndromes. 5. Provide the reader with the information to make optimal, institution-spe cific formulary decisions about glycoprotein IIb/IIIa inhibitors based on t heir clinical pharmacology, efficacy in different patient populations, side effects, and cost-effectiveness.