2026 Eastern States Conference

Title: Reducing cangrelor use in the intensive care unit  
Authors: Maliha Akter, PharmD; Nadia Ferguson PharmD, BCPS, BCCCP; Pooja Kumar, PharmD, BCCCP
Learning Objective: At the conclusion of my presentation, the participant will be able to evaluate inappropriate cangrelor prescribing in the intensive care unit (ICU).
Background: Reduce the proportion of ICU cangrelor orders exceeding 0.75 mcg/kg/min by 50% within six months of implementation.
Methods: Create a clinical pharmacist led multidisciplinary intervention to optimize cangrelor use. Establish criteria for ongoing use beyond institutional protocols for PCI and neurointerventional stenting, and for antiplatelet bridging in high-risk patients. Pharmacist-led stewardship activities included daily prospective review of active orders providing recommendations for initiation, de-escalation, or discontinuation of inappropriate orders. With future plans for next steps standardization of algorithm to implement EMR guidance for appropriate timing and dosing of oral P2Y12 inhibitor continuation.
Results: TBD
Conclusion: By creating standardized use criteria and EMR-based decision support, this initiative seeks to mitigate the risks and costs associated with off-label cangrelor use while ensuring safe transitions to oral antiplatelet therapy in high-risk ICU populations.
Self-Assessment Question: What role can pharmacists have in managing inappropriate orders of cangrelor?