Tenecteplase: Difference between revisions
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==Adult Dosing== | ==Adult Dosing== | ||
===[[Acute 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]]=== | ===[[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> | ||
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*80-89kg: 45 mg IV bolus over 5s | *80-89kg: 45 mg IV bolus over 5s | ||
*>90 kg: 50 mg IV bolus over 5s | *>90 kg: 50 mg IV bolus over 5s | ||
==Pediatric Dosing== | ==Pediatric Dosing== | ||
''Safety/efficacy not established'' | ''Safety/efficacy not established'' | ||
Revision as of 02:40, 3 February 2024
Administration
- Type: Thrombolytic
- Dosage Forms:
- Routes of Administration: IV
- Common Trade Names:
Adult Dosing
Acute ischemic stroke
- 0.25 mg/kg (max 25 mg)[1]
Thrombolysis for PE
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
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.
- Micromedex