Tenecteplase: Difference between revisions
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==Administration== | ==Administration== | ||
*Type: | *Type: [[Thrombolytic]] | ||
*Dosage Forms: | *Dosage Forms: | ||
*Routes of Administration: | *Routes of Administration: IV | ||
*Common Trade Names: | *Common Trade Names: | ||
==Adult Dosing== | ==Adult Dosing== | ||
'''[[Ischemic stroke]]''' | |||
*0.25 mg/kg (max 25 mg)<ref>Powers WJ, Rabinstein AA, Ackerson T, et al. Guidelines for the early management of patients with acute ischemic stroke: 2019 update to the 2018 guidelines for the early management of acute ischemic stroke: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2019;50(12):e344-e418. doi:10.1161/STR.0000000000000211 [PubMed 31662037]</ref> | |||
'''[[Thrombolysis for PE]]''' | |||
*50 mg bolus or 0.5 mg/kg bolus <ref>Fatovich D, Dobb G, Clugston R. A pilot randomised trial of thrombolysis in cardiac arrest (The TICA trial). Resuscitation. 2004;61(3):309-313.</ref><ref>Bozeman W, Kleiner D, Ferguson K. Empiric tenecteplase is associated with increased return of spontaneous circulation and short term survival in cardiac arrest patients unresponsive to standard interventions. Resuscitation. 2006;69(3):399-406.</ref><ref>Böttiger B, Arntz H, Chamberlain D, et al. Thrombolysis during resuscitation for out-of-hospital cardiac arrest. N Engl J Med. 2008;359(25):2651-2662.</ref> | *50 mg bolus or 0.5 mg/kg bolus <ref>Fatovich D, Dobb G, Clugston R. A pilot randomised trial of thrombolysis in cardiac arrest (The TICA trial). Resuscitation. 2004;61(3):309-313.</ref><ref>Bozeman W, Kleiner D, Ferguson K. Empiric tenecteplase is associated with increased return of spontaneous circulation and short term survival in cardiac arrest patients unresponsive to standard interventions. Resuscitation. 2006;69(3):399-406.</ref><ref>Böttiger B, Arntz H, Chamberlain D, et al. Thrombolysis during resuscitation for out-of-hospital cardiac arrest. N Engl J Med. 2008;359(25):2651-2662.</ref> | ||
'''[[Acute myocardial infarction]]''' | |||
*<60kg: 30mg IV bolus over 5s | |||
*60-69kg: 35 mg IV bolus over 5s | |||
*70-79 kg: 40 mg IV bolus over 5s | |||
*80-89kg: 45 mg IV bolus over 5s | |||
*>90 kg: 50 mg IV bolus over 5s | |||
==Pediatric Dosing== | ==Pediatric Dosing== | ||
''Safety/efficacy not established'' | |||
==Special Populations== | ==Special Populations== | ||
===[[Drug pregnancy categories|Pregnancy Rating]]=== | ===[[Drug pregnancy categories|Pregnancy Rating]]=== | ||
* | *Pregnancy category C (fetal risk cannot be ruled out) | ||
===Lactation risk=== | ===Lactation risk=== | ||
* | *Infant risk cannot be ruled out | ||
===Renal Dosing=== | ===Renal Dosing=== | ||
*Adult: | *Adult: not established | ||
===Hepatic Dosing=== | ===Hepatic Dosing=== | ||
*Adult: | *Adult: not established | ||
==Contraindications== | ==Contraindications== | ||
*Allergy to class/drug | *Allergy to class/drug | ||
*Active internal bleeding | |||
*Known bleeding diathesis | |||
*Recent (<2m) intracranial or intraspinal surgery or trauma | |||
*Intracranial neoplasm, AVM, or aneurysm | |||
*History of CVA | |||
*Severe, uncontrollable hypertension | |||
==Adverse Reactions== | ==Adverse Reactions== | ||
===Serious=== | ===Serious=== | ||
*Upon coronary reperfusion: [[Dysrhythmia]], cholesterol embolus (rare) | |||
*Major hemorrhage, [[GI bleed]], [[intracranial hemorrhage]], renal artery hemorrhage | |||
*[[CVA]] | |||
*[[Thromboembolism]] | |||
*[[Anaphylaxis]], hypersensitivity reaction | |||
===Common=== | ===Common=== | ||
*Minor hemorrhage: hematoma, GI bleed, renal artery hemorrhage | |||
==Pharmacology== | ==Pharmacology== | ||
*Half-life: | *Half-life: 90-130m | ||
*Metabolism: | *Metabolism: Hepatic | ||
*Excretion: | *Excretion: | ||
==Mechanism of Action== | ==Mechanism of Action== | ||
*Binds fibrin, converts plasminogen to plasmin | |||
==Comments== | ==Comments== | ||
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==See Also== | ==See Also== | ||
*[[Thrombolysis]] | |||
*[[Thrombolysis for PE]] | |||
*[[Thrombolytics in STEMI]] | |||
==References== | ==References== | ||
Latest revision as of 18:02, 28 February 2024
Administration
- Type: Thrombolytic
- Dosage Forms:
- Routes of Administration: IV
- Common Trade Names:
Adult Dosing
- 0.25 mg/kg (max 25 mg)[1]
- <60kg: 30mg IV bolus over 5s
- 60-69kg: 35 mg IV bolus over 5s
- 70-79 kg: 40 mg IV bolus over 5s
- 80-89kg: 45 mg IV bolus over 5s
- >90 kg: 50 mg IV bolus over 5s
Pediatric Dosing
Safety/efficacy not established
Special Populations
Pregnancy Rating
- Pregnancy category C (fetal risk cannot be ruled out)
Lactation risk
- Infant risk cannot be ruled out
Renal Dosing
- Adult: not established
Hepatic Dosing
- Adult: not established
Contraindications
- Allergy to class/drug
- Active internal bleeding
- Known bleeding diathesis
- Recent (<2m) intracranial or intraspinal surgery or trauma
- Intracranial neoplasm, AVM, or aneurysm
- History of CVA
- Severe, uncontrollable hypertension
Adverse Reactions
Serious
- Upon coronary reperfusion: Dysrhythmia, cholesterol embolus (rare)
- Major hemorrhage, GI bleed, intracranial hemorrhage, renal artery hemorrhage
- CVA
- Thromboembolism
- Anaphylaxis, hypersensitivity reaction
Common
- Minor hemorrhage: hematoma, GI bleed, renal artery hemorrhage
Pharmacology
- Half-life: 90-130m
- Metabolism: Hepatic
- Excretion:
Mechanism of Action
- Binds fibrin, converts plasminogen to plasmin
Comments
See Also
References
- ↑ Powers WJ, Rabinstein AA, Ackerson T, et al. Guidelines for the early management of patients with acute ischemic stroke: 2019 update to the 2018 guidelines for the early management of acute ischemic stroke: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2019;50(12):e344-e418. doi:10.1161/STR.0000000000000211 [PubMed 31662037]
- ↑ Fatovich D, Dobb G, Clugston R. A pilot randomised trial of thrombolysis in cardiac arrest (The TICA trial). Resuscitation. 2004;61(3):309-313.
- ↑ Bozeman W, Kleiner D, Ferguson K. Empiric tenecteplase is associated with increased return of spontaneous circulation and short term survival in cardiac arrest patients unresponsive to standard interventions. Resuscitation. 2006;69(3):399-406.
- ↑ Böttiger B, Arntz H, Chamberlain D, et al. Thrombolysis during resuscitation for out-of-hospital cardiac arrest. N Engl J Med. 2008;359(25):2651-2662.