Medication reconciliation revealed he was taking dabigatran 150 mg twice a day, with the last dose being 179 minutes before presentation. [ncbi.nlm.nih.gov]

• Disability

  Although prior major trials of alteplase included patients with low NIHSS scores, few without clearly disabling deficits were enrolled. [ncbi.nlm.nih.gov]

  The stoppage was initiated by the sponsor which raises concerns about access to data Selection bias: it was up to providers to determine if the deficits present were disabling or non-disabling Discussion: The study was stopped early by the pharmaceutical [rebelem.com]

  Vessel reperfusion may avert disability because of the first 2 of these reasons. [jamanetwork.com]

  […] affairs without assistance, 3: Moderate disability requiring some help, but able to walk without assistance, 4: Moderately severe disability, unable to walk without assistance and unable to attend to own bodily needs without assistance, 5: Severe disability [clinicaltrials.gov]

• Intravenous Administration

  (1,5 million units within 60 minutes) together with hypodermic or intravenous administration of heparin (7,3%). [en.medicalmeds.eu]

  Dosage and using this medicine Activase® (alteplase) is for intravenous administration only. It is important that you consult your doctor or pharmacist on how to use the medication correctly and follow all instructions carefully. [alteplase.com]

  Program an infusion pump to flush the IV tubing following administration of treatment dose. Activase is for intravenous administration only. Extravasation of Activase infusion can cause ecchymosis or inflammation. [activase.com]

  Activase® (Alteplase) is for intravenous administration only. [globalrph.com]

• Falling

  PHYSICAL THERAPY IMPLICATIONS Examination and Evaluation Assess for signs of bleeding and hemorrhage (bleeding gums; nosebleed; unusual bruising; coughing up blood; black, tarry stools; hematuria; fall in hematocrit or blood pressure). [fadavispt.mhmedical.com]

  Alteplase falls into category C. In animal studies, pregnant animals were given this medication and had some babies born with problems. No well-controlled studies have been done in humans. [rxwiki.com]

  Use care to prevent injury and avoid falls or crashes. This drug may affect certain lab tests. Tell all of your health care providers and lab workers that you take this drug. [mskcc.org]

  Patients with acute CI suffer a lot, and their falling health is associated with factors such as gender, age, stoke severity, and dementia [ 4 ]. [bioscirep.org]

• Pleural Effusion

  In an attempt to increase the drainage of the pleural effusion, alteplase 16 mg was administered into the pleural cavity via the chest tube on 6 consecutive days. [ncbi.nlm.nih.gov]

  The use of fibrinolytics for the percutaneous drainage of loculated pleural effusions has been shown to reduce the catheter dwell time and to improve drainage of the effusions. [clinicaltrials.gov]

  Treatment of pleural empyema. J Paediatr Child Health. 2000 ; 36 : 375 – 377 ↵ Park CS, Chung WM, Lim MK, et al. Transcatheter instillation of urokinase into loculated pleural effusion: analysis of treatment effect. [pediatrics.aappublications.org]

• Nausea

  GI: GI BLEEDING, nausea, RETROPERITONEAL BLEEDING, vomiting. GU: GU TRACT BLEEDING. Derm: ecchymoses, flushing, urticaria. Hemat: BLEEDING. Local: hemorrhage at injection site, phlebitis at injection site. MS: musculoskeletal pain. [fadavispt.mhmedical.com]

  Also call your doctor at once if you have: chest pain or heavy feeling, pain spreading to the jaw or shoulder, nausea, sweating, general ill feeling; swelling, rapid weight gain, little or no urination; severe stomach pain, nausea, and vomiting; darkening [everydayhealth.com]

• Thrombosis

  Larger cohorts are required to confirm safety, including bleeding complications and the risk of thrombosis. [ncbi.nlm.nih.gov]

  The management of filter-related caval thrombosis complicated by heparin-induced thrombocytopenia and thrombosis. Int J ClinExp Med2015;8:13078-88. Nitta N, Shitara S, Nozaki K. [jbclinpharm.org]

• Bleeding Gums

  PHYSICAL THERAPY IMPLICATIONS Examination and Evaluation Assess for signs of bleeding and hemorrhage (bleeding gums; nosebleed; unusual bruising; coughing up blood; black, tarry stools; hematuria; fall in hematocrit or blood pressure). [fadavispt.mhmedical.com]

  Call your doctor or get emergency medical help if you have signs of bleeding, such as: sudden headache, feeling very weak or dizzy; bleeding gums, nosebleeds; easy bruising; bleeding from a wound, incision, catheter, or needle injection; bloody or tarry [everydayhealth.com]

  Bleeding in various sites, including nosebleeds, bleeding gums, blood in the urine, bleeding in the throat or gut, coughing or vomiting blood. A blood transfusion may sometimes be needed. Heart attack. [netdoctor.co.uk]

• Epistaxis

  A percutaneous mechanical thrombectomy and CDT with alteplase were attempted, but the procedure was aborted due to epistaxis. The epistaxis resolved the next day, and the patient was restarted on argatroban. [ncbi.nlm.nih.gov]

  […] requires an admission to 7 West Indications Unable to use Central Venous Catheter Unable to aspirate blood/Heplock prior to Haemodialysis Adverse Reactions Bleeding - from recent puncture or IV sites - this requires careful nursing attention Echymosis, epistaxis [rch.org.au]

  EENT: epistaxis, gingival bleeding. Resp: bronchospasm, hemoptysis. CV: reperfusion arrhythmias, hypotension, RECURRENT ISCHEMIA/THROMBOEMBOLISM. GI: GI BLEEDING, nausea, RETROPERITONEAL BLEEDING, vomiting. GU: GU TRACT BLEEDING. [fadavispt.mhmedical.com]

• Stroke

  According to a report at the Stroke Conference by Dr. [mdedge.com]

  Seven patient factors were individually predictive of increased likelihood of immediately offering IV alteplase (compared to reference levels in brackets): stroke onset time 2 h 30 min [50 min]; pre-stroke dependency mRS 3 [mRS 4]; systolic blood pressure [ncbi.nlm.nih.gov]

• Intracranial Hemorrhage

  KEYWORDS: alteplase; intracranial hemorrhages; stroke; thrombolytic therapy; treatment outcome [ncbi.nlm.nih.gov]

  Contraindications Acute Ischemic Stroke Do not administer to treat acute ischemic stroke in the following situations in which the risk of bleeding is greater than the potential benefit Current intracranial hemorrhage Subarachnoid hemorrhage Active internal [reference.medscape.com]

• Pleural Effusion

  In an attempt to increase the drainage of the pleural effusion, alteplase 16 mg was administered into the pleural cavity via the chest tube on 6 consecutive days. [ncbi.nlm.nih.gov]

  The use of fibrinolytics for the percutaneous drainage of loculated pleural effusions has been shown to reduce the catheter dwell time and to improve drainage of the effusions. [clinicaltrials.gov]

  Treatment of pleural empyema. J Paediatr Child Health. 2000 ; 36 : 375 – 377 ↵ Park CS, Chung WM, Lim MK, et al. Transcatheter instillation of urokinase into loculated pleural effusion: analysis of treatment effect. [pediatrics.aappublications.org]

Treatment of sICH is based on expert opinion and small case series, with the efficacy of such treatments not well established. This document aims to provide an overview of sICH with a focus on pathophysiology and treatment. [ncbi.nlm.nih.gov]

The aim of treatment is to reduce the impact of ischaemia by restoring blood flow through the occluded (blocked) artery. [nice.org.uk]

If the treatment is not successful after twice administrating the medication The Haematology Unit Consultant - Paul Monagle pager no. 5827 will need to be consulted. [rch.org.au]

In patients randomized CONCLUSIONS: These exploratory analyses of the third International Stroke Trial (IST-3) trial support improving acute stroke patients' access to earlier alteplase treatment, treatment of patients with poor prognosis, and further [ncbi.nlm.nih.gov]

Alteplase Helpful Soon after Stroke, Maybe Even with Poor Prognosis Submitted by Stephanie Vaccaro on December 10, 2014 - 11:59am At 18 months after stroke, patients treated with alteplase did not have a higher mortality rate, in a new study. [naccme.com]

Maas AI, Murray GD, Roozenbeek B, Lingsma HF, Butcher I, McHugh GS, et al.; International Mission on Prognosis Analysis of Clinical Trials in Traumatic Brain Injury (IMPACT) Study Group. [ahajournals.org]

Maas AI, Murray GD, Roozenbeek B, Lingsma HF, Butcher I, McHugh GS, et al. ; International Mission on Prognosis Analysis of Clinical Trials in Traumatic Brain Injury (IMPACT) Study Group. [stroke.ahajournals.org]

•. acute myocardial infarction and pulmonary embolism • Hemorrhagic stroke or stroke of unknown etiology in history. • Ischemic stroke or transient ischemic attacks in the last 6 months. [although.ru]

[…] components In case of use of drug for treatment of an acute myocardial infarction and an embolism of a pulmonary artery, in addition to above-mentioned, there is the following contraindication: - The Gemmorragichesky stroke or a stroke of an unknown etiology [en.medicalmeds.eu]

Data Collection and Monitoring Key clinical and radiological data were collected, including (1) baseline neuroimaging and NIHSS score; (2) 22- to 36-hour repeat neuroimaging and NIHSS score; (3) 5-day (or discharge if sooner) NIHSS score, stroke etiology [jamanetwork.com]

Outcome by stroke etiology in patients receiving thrombolytic treatment: descriptive subtype analysis. Stroke. 2011 ; 42 :102–106. doi: 10.1161/STROKEAHA.110.597534. Link Google Scholar 435. [stroke.ahajournals.org]

METHODS: A literature review was performed for randomized trials, prospective and retrospective studies, opinion papers, case series, and case reports on the definitions, epidemiology, risk factors, pathophysiology, treatment, and outcome of sICH. [ncbi.nlm.nih.gov]

Kleindorfer, Opeolu M Adeoye, Andrew M Demchuk, Jennifer E Fugate, James C Grotta, Alexander A Khalessi, Elad I Levy, Yuko Y Palesch, Shyam Prabhakaran, Gustavo Saposnik, Jeffrey L Saver, Eric E Smith, American Heart Association Stroke Council and Council on Epidemiology [pubmed.ncbi.nlm.nih.gov]

He has completed fellowship training in both intensive care medicine and emergency medicine, as well as post-graduate training in biochemistry, clinical toxicology, clinical epidemiology, and health professional education. [litfl.com]

Kleindorfer (vice chair), and colleagues on the AHA Stroke Council and Council on Epidemiology and Prevention reviewed the guidelines and exclusions, warnings, risks, and contraindications for alteplase, the only tPA licensed for use in acute ischemic [consultant360.com]

This document aims to provide an overview of sICH with a focus on pathophysiology and treatment. [ncbi.nlm.nih.gov]

IV push alteplease is always a disturbing thought for pharmacists but remember the pathophysiology – if the clot doesn’t go away, the patient will not get any oxygen. [pharmacyjoe.com]

Major pulmonary embolism: review of a pathophysiologic approach to the golden hour of hemodynamically significant pulmonary embolism. Chest. 2002;121:877-905. Tan KT, Oudkerk M, van Beek EJR. Deep Vein Thrombosis and Pulmonary Embolism. [activase.com]

Clinical Topics: Anticoagulation Management, Dyslipidemia, Prevention, Lipid Metabolism Keywords: Activities of Daily Living, Anticoagulants, Aspirin, Brain Ischemia, Intracranial Hemorrhages, Primary Prevention, Risk, Stroke, Tissue Plasminogen Activator [acc.org]

Alteplase has been shown to be effective in preventing central venous access clotting in patients on hemodialysis. [ncbi.nlm.nih.gov]

Use extra care to prevent bleeding while shaving or brushing your teeth. [everydayhealth.com]

a recombinant form of tissue plasminogen activator that is used to prevent damage to heart muscle following a heart attack and to reduce neurological damage following ischemic stroke Intravenous thrombolytic treatment with alteplase, initiated within [merriam-webster.com]

Heart Attack Prevention Heart disease and heart attacks can be prevented by leading a healthy lifestyle with diet, exercise, and stress management.... Stroke Prevention Stroke is the third leading killer in the United States. [medicinenet.com]