Heparin vs Integrilin

[meglp17]

I work on a cardiac step down unit where the cardiologists typically start nitro and heparin on mostly anyone coming in with chest pain. I was pulled to CCU last night where a patient was having active chest pain, diaphoretic, nausea and vomiting. The cardiologist ordered integrilin IV.

Just wondering if someone could explain the patho behind integrilin and the benefits of its use over heparin.

[ckh23, BSN, RN]

I work on a cardiac step down unit where the cardiologists typically start nitro and heparin on mostly anyone coming in with chest pain. I was pulled to CCU last night where a patient was having active chest pain, diaphoretic, nausea and vomiting. The cardiologist ordered integrilin IV.

Just wondering if someone could explain the patho behind integrilin and the benefits of its use over heparin.

One works on the platelets themselves and the other on the clotting cascade.

Heparin will increase the effects of antithrombin III which will inhibit factors IIa (thrombin) and factor Xa, thus it will essentially block the intrinsic and final common pathways.

Integrilin is a GP IIb/IIIa inhibitor and it basically blocks the fibrinogen receptor on the platelet. By blocking this receptor, you prevent the attachement of fibrinogen so you will not get platelet aggregation. This is helpful in patients that may be having chest pain that is being caused by a thrombus.