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10 Cards in this Set
- Front
- Back
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Class
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Fibrinolytic
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Mechanism of Action
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The enzyme binds to the fibrin bound plasminogen at the clot site, converting plasminogen to plasmin. Plasmin digests the fibrin strands of the clot, restoring perfusion.
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Indications
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Acute MI, STEMI, massive pulmonary emboli, acute ischemic cerebrovascular accident
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Contraindications
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Active internal bleeding, recent surgery (within 2-3 weeks), previous cerebrovascular accident or seizure at onset, prolonged CPR,intracranial or intraspinal surgery (w/ in 3 months), intracranial neoplasm, arteriovenous malformation, or aneurysm, recent significant trauma especially head trauma. Uncontrolled hypertension (systolic >185, diastolic >110)
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Adverse reactions/ side effect
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Intracranial bleeding, headache, reperfusion, dysrhythmias, chest pain, hypotension, GI bleeding, nausea, vomiting, abd pain
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Drug Interactions
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Acetylsalicylic acid (aspirin) may increase risk of bleeding hemorrhage. Heparin and other anti-coagulants may increase risk or hemorrhage
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How Supplied
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50 and 100 mg powders (requires reconstitution with sterile water to a concentration of 1 mg/mL)
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Dosage and admin
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Adult: 15 mg IV bolus over 2 min, then .75 mg/kg over 30 min (not to exceed 50 mg); then .50 mg/kg over 60 min, maximum total dose of 100 mg. For acute ischemic stroke, .9 mg 1 kg infused over 60 min; administer 10% of total dose in 1 min and rest over next 60 min.
Pedi: safety not established |
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Duration of Action
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Onet: Clot lysis most often within 60-90 minutes
Peak effect:Variable Duration: 30 minutes with 80% cleared within 10 min |
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Special Consideration
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Pregnancy safety. Cat. C. Closely monitor V/S. Observe for bleeding. Do not administer IM injections to pt receiving tissue plasminogen activator. Only administer with an infusion pump. Due to severe spontaneous bleeding risk, invasive procedures (eg. IV starts, injections, NG tube, nasotracheal intubation) should be avoided.
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