Look inside the book: Nursing 2025-2026 Drug Handbook

cangrelor 219

INDICATIONS & DOSAGES ➤ Adjunct to PCI for reducing risk of periprocedural MI, repeat coronary revas cularization, and stent thrombosis in pa tients who haven’t been treated with a P2Y 12 platelet inhibitor and aren’t receiv ing a glycoprotein IIb/IIIa inhibitor Adults: 30 mcg/kg IV bolus before PCI fol lowed immediately by a 4 mcg/kg/minute IV infusion continued for at least 2 hours or for duration of PCI, whichever is longer. Transi tion patient to oral P2Y 12 platelet inhibitor to maintain platelet inhibition. Recommended inhibitors include ticagrelor 180 mg PO at any time during infusion or immediately after discontinuation; or, prasugrel 60 mg or clopi dogrel 600 mg immediately after infusion dis continuation. ADMINISTRATION IV For each 50-mg vial, reconstitute by adding 5 mL sterile water for injection. Swirl gently until dissolved; avoid vigorous mixing. Ensure contents are fully dissolved, clear, colorless to pale yellow, and free from particulate matter. Immediately dilute reconstituted drug. Don’t use without dilution. Further dilute each reconstituted vial by withdrawing contents from one reconsti tuted vial and adding to one 250-mL NSS or dextrose 5% bag. Mix bag thoroughly. This dilution results in a concentration of 200 mcg/mL and should be sufficient for at least 2 hours of dosing. Patients weighing 100 kg or more require a minimum of two bags. Discard any unused portion of reconsti tuted solution remaining in vial. Administer via a dedicated IV line. Administer bolus volume rapidly (over less than 1 minute) from the diluted bag via manual IV push or pump. Ensure bolus is completely administered before start of PCI. Start infusion immediately after bolus ad ministration. Diluted drug remains stable for up to 12 hours in 5% dextrose injection and 24 hours in NSS at room temperature. Incompatibilities: None listed by manu facturer. Consult drug compatibility refer ence for more information.

ACTION Direct P2Y 12 platelet receptor inhibitor that blocks ADP-induced platelet activation and aggregation. Binds selectively and reversibly toP2Y 12 platelet receptor to prevent further signaling and platelet activation. Route Onset Peak Duration IV 2 min 2 min 1 hr after discontinuation of infusion Half-life: 3 to 6 minutes. ADVERSE REACTIONS CNS: intracranial hemorrhage. CV: hem orrhage. GU: worsening kidney function in patients with CrCl less than 30 mL/minute. Respiratory: dyspnea. INTERACTIONS Drug-drug. Agents with antiplatelet prop erties (NSAIDs, SSRIs): May enhance an tiplatelet effects. Monitor therapy. Anticoagulants: May increase anticoagulant effects. Monitor therapy. Thienopyridines (P2Y 12 platelet inhibitors clopidogrel, prasugrel, and ticagrelor): Negate antiplatelet effect. Don’t give thienopyridines until cangrelor infusion has been discontinued. EFFECTS ON LAB TEST RESULTS • May inhibit platelet aggregation. CONTRAINDICATIONS & CAUTIONS • Contraindicated in patients hypersensitive to drug or its components and in those with significant active bleeding. • Drug can cause serious hypersensitivity reactions (anaphylaxis, bronchospasm, an gioedema, stridor). • Safety and effectiveness in children haven’t been established. • Dialyzable drug: Unlikely. PREGNANCY-LACTATION-REPRODUCTION • Studies during pregnancy are inadequate. Untreated MI can be fatal. • When possible, discontinue cangrelor 1 hour before labor, delivery, or neuraxial blockade. • It isn’t known if drug appears in human milk. Use cautiously during breastfeeding.


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