Perform venipunctures carefully and only as required. The recommended treatment dose is 100 mg administered by intravenous iv infusion over 2 hours. Our practice is to reconstitute 8 mgs of activase in 10 ccs of saline. Some of the dosage forms listed on this page may not apply to the brand name activase in summary. These dissolve blood clots quickly to help restart blood flow to the heart and helps prevent damage to the heart muscle. Activase side effects, uses, dosage, overdose, pregnancy. A version of this article originally appeared on the emergency medicine pharmd blog. Thrombolytic pregnancy risk category c action converts plasminogen to plasmin, which in turn breaks down fibrin and fibrinogen, thereby dissolving thrombus availability injection.
Using cathflo activase in patients with infected catheters may release a localized infection into the systemic circulation. Activase alteplase is indicated for the treatment of acute ischemic stroke ais. Is there a protocol in the use of activase for pd cath. Patients with acute ischemic stroke who underwent alteplaseinduced. Exclude intracranial hemorrhage as the primary cause of stroke signs and symptoms prior to initiation of treatment see contraindications 4. Alteplase is indicated for use in the management of acute myocardial infarction, ischemic stroke, and for the management of acute massive pulmonary embolism pe in adults. Institute parenteral anticoagulation near the end of or immediately following the activase infusion when the partial thromboplastin time or thrombin time returns to twice normal or less. Activase alteplase dose, indications, adverse effects. Your childs doctor will determine the appropriate dose by taking into account your childs weight, height, age, and other factors. A healthcare provider will give you this injection. Teiken, md, surgical and combined intensive care units gary e. Exclude intracranial hemorrhage as the primary cause of stroke signs and symptoms prior to initiation of treatment.
Acute management of pulmonary embolism american college. There are two activase dose regimens accelerated and 3hour for use in the management. Tnkase tenecteplase is a tissue plasminogen activator tpa produced by. During and following activase administration for the treatment of acute ischemic stroke, frequently monitor and control blood pressure. Activase therapy for acute ischemic stroke management. Cathflo activase alteplase for injection is a sterile, white to pale yellow, lyophilized powder for intracatheter instillation for restoration of function to central venous access devices following reconstitution with sterile water for injection, usp. Contraindications for cathflo activase intracatheter. Alteplase rtpaactivase dosage administration allina health. Guidelines on the administration of actilyse beaumont hospital. If extravasation occurs, terminate the infusion at that iv site and apply local therapy. As the public becomes more informed about the signs and symptoms of stroke, people are. Activase is a prescription medication used to break up or dissolve blood clots. Thus, only the recommended dose of alteplase was used for. Guidelines for use of tpa activase treatment in acute ischemic stroke physician to check appropriate boxes treatment of acute ischemic stroke with tpa activase must be initiated within 3 hours of stroke symptom onset.
Pdr drug summaries are concise pointofcare prescribing, dosing and administering information to help phsyicans more efficiently and accurately prescribe in their practice pdr s drug summaries are available free of charge and serve as a great resource for us based mds, dos, nps and pas in patient practice. Cathflo activase alteplase 2 cathflo activase 3 alteplase 4 powder for reconstitution for use in central venous access 5 devices 6 description 7 cathflo activase alteplase is a tissue plasminogen activator tpa 8 produced by recombinant dna technology. Consent to administer alteplase tpa i understand that. Extravasation of activase infusion can cause ecchymosis or inflammation. Clinical pharmacokinetics is the application of pharmacokinetic principles to the safe and effective therapeutic management of drugs in an individual patient. Fatal cases of hemorrhage associated with traumatic intubation in patients administered activase have been reported. What is the procedure for activase dwell in a pd catheter. Changes to the prescribing information for alteplase activase rtpa pertaining to contraindications to the drugs use in acute ischemic stroke ais recently flew in under the radar.
Ismp s list of confused drug names contains lookalike and soundalike lasa name pairs, of medications that have been published in the ismp medication safety alert. It can be used as a thrombolytic agent to hydrolyse fibrin and fibrinogen. Highlights of prescribing information acute ischemic. There are two activase dose regimens accelerated and 3hour for use in. Activase is used to break up a fibrin clot in the pd catheter.
Fbn 2459 and the north carolina nurses association. Inclusion criteria all yes boxes must be checked before thrombolytics are given yes no. The infusion should begin immediately following the bolus. Pocket reference for icu staff critical care medicine services 2000 2nd edition tripler army medical center honolulu, hi prepared by. This chemical dosing system uses an electronically controlled peristaltic pump to. Clinical applicants specialist bracco diagnostics inc. Learn vocabulary, terms, and more with flashcards, games, and other study tools. Fibrinolytic agents alteplase recombinant tissuetype plasminogen activator, tpa naturally occurring enzyme serine protease in contrast to streptokinase, it is fibrinspecific fibrinbound tpa has increased affinity for plasminogen and enhances its activation. Pdf for the last 15 years, alteplase recombinant tissue plasminogen. The seattle ii a prospective, singearm, multicenter trial of ekosonicr endovascular system and activase for treatment of acute pulmonary embolism study, 48 was a single arm multicenter trial of uacdt that demonstrated improved right ventricular hemodynamic indices in patients undergoing uacdt for both massive and submassive pe. Activase is for intravenous iv administration only.
Reperfusion therapy for acute myocardial infarction. Aggrastat is a reversible antagonist of fibrinogen binding to the gp iibiiia receptor, the major platelet surface receptor involved in platelet aggregation. Evaluating patient eligibility, dosing and administration, activase post. Alteplase injection activase is a tissue plasminogen activator produced by recombinant dna technology. Assess for menses in women, recent surgery or trauma, bleeding disorders, or history of. Reperfusion therapy for acute myocardial infarction jason s. Cathflo activase genentech, drug reference encyclopedia.
Activase is a tissue plasminogen activator tpa indicated for the treatment of. Avoid intramuscular injections and trauma to the patient. Alteplase twice on two separate occassions within a two week period. These conditions are more commonly known as heart attack and stroke, respectively. When administered intravenously, aggrastat inhibits ex vivo platelet aggregation in a dose and concentrationdependent manner. Cathflo 2 mg is the standard of care for treatment of thrombotically occluded catheters. Go, md, facc interventional cardiology and peripheral vascular intervention altru health system. It is a sterile, purified glycoprotein of 527 amino acids. Activity and dosage of alteplase dilution for clearing occlusions of venousaccess devices. Using sterile technique, remove the mini cap or other catheter cap, attach the syringe and gently inject the whole 10ccs. Obtain complete health history, including allergies, drug history, and possible drug interactions. Patients can be booked into the renal day care ward on ext. Initiate treatment as soon as possible but within 3 hours after symptom onset.
Actilyse uk, activase, activase rtpa ca, cathflo activase pharmacologic class. Nonfibrinbound tpa does not extensively activate plasminogen. Patients receiving alteplase potential nursing diagnoses. Cathflo activase alteplase powder for reconstitution for. Activase definition of activase by medical dictionary. Orlando regional healthcare is an approved provider of continuing nursing education by florida board of nursing provider no. It is synthesized using the complementary dna cdna for natural human tissue. Monitoring patients in the first 24 hours activase.
Follow these guidelines for the dosing and administration of activase 6. Alteplase tpa lyses fibrin clots within the catheter lumen which may. If you continue browsing the site, you agree to the use of cookies on this website. This document contains side effect information about alteplase. Find out what health conditions may be a health risk when taken with cathflo activase intracatheter. Indications activase alteplase is indicated for the treatment of acute ischemic stroke. Pdf effects of alteplase in the treatment of acute ischemic stroke.
Introduction in this video, we will demonstrate how to reconstitute, dose, and administer alteplase, or. This information will be given to you, along with exact instructions and a dosing sheet. Consent to administer alteplase tpa physician name. Have second practitioner independently check original order, dose calculations, and infusion pump settings. Reconstitution, dosing, and administration narrator reads the following script while pharmacist demonstrates the steps for reconstituting intravenous rtpa. The recommended total dose should not exceed 50 mg and is. Cathflo activase should be used with caution in the presence of known or suspected infection in the catheter. Administer activase as soon as possible but within 3 hours after onset of symptoms. Activase alteplase is indicated for the treatment of acute ischemic stroke. Before using dosing system the steris acusinq chemical dosing system figure 1 is a dispensing system used to transfer precise amounts of presoak chemicals into a prewash sink. Questions about pd vote up 0 vote down resolved public gail g, nurse from georgia asked is there a protocol in the use of activase for pd cath. Alteplase tpa treatment for peritonitis and peritoneal catheter malfunction, alteplase tpa is a fibrinolytic agent. Any local ems system changes to this document must follow the nc oems.
Introduction to pharmacokinetics and pharmacodynamics. As with all catheterization procedures, care should be. Webmd provides common contraindications for cathflo activase intracatheter. A patient that keeps staph epi peritonitis after treatment with antibiotics 1 answer vote up 0 vote down public asktheexpertteam. Acute ischemic stroke intravenous thrombolysis chart.
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