Tenecteplase Flashcards
1
Q
What is tenecteplase?
A
Tenecteplase (50mg(10 000 IU) powder & solvent) is a thrombolytic agent which combines with the fibrin component of the thrombus and converts thrombus-bound plasminogen to plasma. This degrades the fibrin matrix of the thrombus.
Hepatic metabolism
Onset: 15 min
Duration: several hrs
Half-life: 2 hrs
2
Q
Indications for tenecteplase?
A
- Patient with STEMI who meet the criteria for prehospital tenecteplase administration (as defined by the relevant QAS coronary artery perfusion checklist)
3
Q
Contraindications for tenecteplase?
A
- Patients less than 18 or greater than 75 years of age
- Uncontrolled hypertension (SBP >180 / DBP >110 mmHg at any stage during current episode)
- Allergy/ADR to any of: tenecteplase, enoxaparin or clopidogrel
- LBBB identified on 12-lead ECG
- Current or history of thrombocytopenia
- Active tuberculosis
- Known cerebral disease, in particular a malignant intracranial neoplasm or arteriovenous malformation
- Prior intracranial haemorrhage
- Ischaemic stroke or TIA in last 3 months
- History of significant close head or facial trauma within last 3 months
- Internal bleeding within last 6 weeks (excludes menses)
- Bleeding or clotting disorder
- Current use of anticoagulants (e.g. warfarin)
- Non-compressive vascular punctures
- Prolonged (>10 min) CPR
- Known to be pregnant/delivered within last 2 weeks
- History of serious systemic disease (advanced stage/terminal cancer, severe liver or kidney disease)
- Resident of an aged care facility requiring significant assistance with ADL
- Acute myocardial infarction in the setting of trauma
4
Q
Precautions for tenecteplase?
A
Nil
5
Q
Side effects of tenecteplase?
A
- Haemorrhage
2. Post-administration dysrhythmias
6
Q
What is the dose of tenecteplase for an adult?
A
Weight calculated: <60 kg - 30mg (6mL) >60 to <70 kg - 35mg (7mL) >70 to <80 kg - 40mg (8mL) >80 to <90 kg 45mg (9mL) >90kg - 50mg (10mL)
