Assessment

• Assess for bleeding. Most common sites are arterial access site for cardiac catheterization or GI or GU tract. Arterial and venous punctures, IM injections, and use of urinary catheters, nasotracheal intubation, and NG tubes should be minimized. Noncompressible sites for IV access should be avoided. If bleeding cannot be controlled with pressure, discontinue eptifibatide and heparin immediately

• Prior to eptifibatide therapy, assess hemoglobin or hematocrit, platelet count, serum creatinine, and PT/aPTT. Activated clotting time (ACT) should also be measured in patients undergoing PCI

» Maintain the aPTT between 50 and 70 sec unless PCI is to be performed. Maintain ACT between 300 and 350 sec during PCI

» Arterial sheath should not be removed unless aPTT <45 sec

» If platelet count decreases to <100,000 and is confirmed, eptifibatide and heparin should be discontinued and condition monitored and treated

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