Progressive Care Nursing Certification (PCCN) Practice Exam

Which condition would contraindicate the use of abciximab (ReoPro) in a patient?

1. previous stroke within 3 years

2. platelet count of 110,000

3. recent warfarin therapy

4. a history of angina

The correct answer is: recent warfarin therapy

Abciximab (ReoPro) is a glycoprotein IIb/IIIa inhibitor primarily used in percutaneous coronary interventions to prevent thrombus formation. When considering the contraindications for its use, it's important to focus on conditions that increase the risk of bleeding or are incompatible with the drug's mechanism of action. Recent warfarin therapy is relevant here because warfarin is an anticoagulant that affects the clotting cascade and could significantly increase the risk of bleeding when administered concurrently with abciximab. Since both drugs impair different aspects of hemostasis—warfarin affecting the coagulation factors in the liver and abciximab inhibiting platelet aggregation—the combination can lead to uncontrolled bleeding, making recent warfarin therapy a contraindication for abciximab. While a previous stroke within the last three years is a concern due to possible hemorrhagic complications, it doesn't categorically contraindicate abciximab in the same manner as a current anticoagulation therapy like warfarin. Similarly, a platelet count of 110,000, although lower than the typical normal range, is still generally considered safe for abciximab, where the absolute contraindication is usually a platelet count below 100