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4 Cards in this Set
- Front
- Back
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Streptokinase (Streprase) (Kabikinase) |
Indication: - deep vein thrombosis - pulmonary embolism - arterial thrombosis and embolism - coronary thrombosis - dissolving clots in arteriovenous cannula
Adverse reaction: - anaphylactic response range from breathing difficulties to bronchospasm, periorbital swelling, or angioneurotic edema - increased risk for bleeding - hemorrhage infarction at site of myocardial damage - reperfusion dysrhythmias
Nursing Implication - assess for bleeding at puncture; apply pressure to control - assess for allergic reaction and dysrhythmias - monitor client's thrombin time after therapy. do not administer herparin or oral anticoagulant until thrombin time is less than twice that of control - do not shake vial when reconstituting; roll and tilt vial gently to mix |
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Tenecteplase (TNKase) Reteplase (Retavase) |
Indication: Acute management of coronary thrombosis
Adverse reaction: do not give if history of uncontrolled HTN - can cause hypotension
Nursing Implication: - obtain baseline studies prior to administration: pt, ptt, cbc, fibrinogen level, renal studies, cardiac studies - check for abnormal pulse, neurologic vital signs, and presence of skin lesions, which may indicate coagulation defects - avoid needle punctures because of the possibility of bleeding; apply pressure of 10 minutes for venous punctures sites and for 30 minutes to arterial punctures sites; follow with pressure dressing - be prepared to treat reperfusion dysrhythimas |
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Urokinase (Abbokinase) |
Indication: pulmonary embolism, coronary embolism, IV catheter clearance
Adverse reaction: - is nonatigenic and does not cause allergic reaction otherwise has the same adverse reactions as those cited for streptokinase
Nursing Implication: - Infuse heparin and an oral anticoagulant following urokinase therapy to prevent rethrombosis - is much more expensive than streptokinase therapy - reconstitute immediately before use |
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Alteplase (Activase) Anistreplase (Eminase) |
Indication: deep vein thrombosis, pulmonary embolism, coronary thrombosis
Adverse reaction: interact with heparin, oral anticoagulants, and antiplatelet drugs to increase the risk for bleeding
Nursing intervention: - alters coagulation only at the thrombus, not systemically (bleeding complications associated with streptokinase and urokinase are reduced with t-PA therapy) - because t-PA is a human protein, allergic response is unlikely to occur - half-life is 3-7 minutes; use immediately |
