Monitor ECG and vital signs closely throughout therapy.
Assess patient for bleeding at all potential bleeding sites (catheter insertion; arterial and venous puncture; cutdown; needle puncture; GI, GU, and retroperitoneal sites) frequently throughout therapy. If serious uncontrollable bleeding occurs, stop abciximab and concurrent heparin therapy.
Check the sheath insertion site and distal pulses of affected leg(s) frequently while femoral artery sheath is in place and for 6 hr after femoral artery sheath is removed. Measure any hematoma and monitor for signs of enlargement.
Monitor for signs of hypersensitivity reaction or anaphylaxis (rash, pruritus, laryngeal edema, wheezing) throughout therapy. If reactions occur, stop abciximab immediately and initiate treatment of anaphylaxis. Epinephrine, dopamine, theophylline, antihistamines, and corticosteroids should be readily available.
Observe patient for mental status changes, asses nose and mouth mucous membranes, and examine urine, stool and emesis for presence of blood. Use care when removing dressings.Lab Test Considerations
Measure platelet count, PT, and aPTT before infusion of abciximab to identify pre-existing hemostatic abnormalities.
» Monitor platelet count prior to therapy, 24 hr following bolus administration, and at 24 hr or before discharge, whichever is first. If platelet count decreases to <100,000/mm3 or 25% of pretreatment levels, verify true thrombocytopenia by additional platelet counts drawn in separate tubes containing EDTA, citrate, or heparin. If true thrombocytopenia is verified, immediately discontinue abciximab.
» If serious uncontrolled bleeding occurs or surgery is required (especially major procedures) within 4872 hr of abciximab therapy, determine bleeding time. Platelet transfusions may partially restore platelet function.