STROKE-tPA MEDICATIONS

From NeuroRehab.wiki

Revision as of 03:41, 21 February 2023 by Dr Appukutty Manickam (talk | contribs) (Imported from text file)
(diff) ← Older revision | Latest revision (diff) | Newer revision → (diff)

SUMMARY

1. Agents: alteplase (dose: 0.9 mg/kg, max: 90 mg) and techneplase, desmoteplase.

2. 4.5 hours from when last know to be well or from midpoint of sleep[1].

3. 9 hours if there is perfusion mismatch[2].

4. If no reperfusion for ischemia then commence anti-platelet agent urgently.

5. Thrombolysis is possible whilst awaiting clot retrieval.


Reference(s)

  1. Parsons, M., Spratt, N., Bivard, A., Campbell, B., Chung, K., Miteff, F., O'Brien, B., Bladin, C., McElduff, P., Allen, C. and Bateman, G., 2012. A randomized trial of tenecteplase versus alteplase for acute ischemic stroke. New England Journal of Medicine, 366(12), pp.1099-1107.
  2. Campbell, B.C., Ma, H., Ringleb, P.A., Parsons, M.W., Churilov, L., Bendszus, M., Levi, C.R., Hsu, C., Kleinig, T.J., Fatar, M. and Leys, D., 2019. Extending thrombolysis to 4· 5–9 h and wake-up stroke using perfusion imaging: a systematic review and meta-analysis of individual patient data. The Lancet, 394(10193), pp.139-147.


Wilkinson, I., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. Get it on Amazon.
Feather, A., Randall, D. and Waterhouse, M. (2020). Kumar And Clark’s Clinical Medicine. 10th ed. S.L.: Elsevier Health Sciences. Get it on Amazon.
Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].