cath lab RN's - angiomax

juscallmegrace · Mar 9, 2006

Quite simply, Angiomax, more desirable (but BIG price tag) has a short half life, ....about 30 minutes. The half life is more so affected by renal status. As opposed to amount given per se. (Normal renal status=30 minutes.,) Angiomax is weight based in mg/kg dosing and inhibits thrombin.

Heparin on the other hand, inhibits prothrombin, and has a longer half life....anywhere from 30 minutes to 2 and a half hours. Wee bit of Heparin=30minutes....something like 10 or 20 units/kg would give you the 30 minute half life, and of course, higher doses increase the half life time. Hospitals like Heparin because its CHEAP. Heparin inhibits prothrombin. In my practice, Angiomax or a drug in the same class Lepirudin, is only used for people with Heparin allergies or HIT (heparin induced thrombocytopenia) :specs:

SEOBowhntr · Mar 10, 2006

what can you tell me about angiomax? the other day I was trying to determine when i should call the CV tech to come pull sheaths - i was looking at things like when the case ended, what the ACT was at the end of the case, how much heparin was used at the end of the case....when all of a sudden a more experienced nurse whizzed by and said "was Angiomax used? if so then you should be able to pull sheaths sooner" I had no time to ask her about her comment or about angiomax...so what is it? thanks

Angiomax will send your ACT's through the roof, and they will stay elevated for long periods of time. We do not check ACT's on Angiomax patients, we generally just pull the sheath an hour after it was given. I know of at least 2 cases when our ICU, which doesn't often get Angiomax patients, still had sheaths in 12-6 hrs later because they were waiting on the ACT to come down. The whole unit has since been educated, but that's what I can tell you from what I've seen of it in the last couple years. I also think we've tended to have less site problems with it vs. Integrilin or Reopro, therefore, it is well liked.