Presentation
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]
Entire Body System
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Intravenous Administration
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]
The solution may be used for intravenous administration within 8 hours following reconstitution when stored between 2 -30 C (36 -86 F). [globalrph.com]
MIX GENTLY LET IT SETTLE (SEVERAL MINUTES) INSPECT SOLUTION The solution may be used for intravenous administration within 8 hours following reconstitution when stored between 2-30 C (36-86 F). [activase.com]
(1,5 million units within 60 minutes) together with hypodermic or intravenous administration of heparin (7,3%). [en.medicalmeds.eu]
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Noncompliance
Because of noncompliance with postoperative thromboprophylaxis, there was high suspicion for PE. [ncbi.nlm.nih.gov]
The per-protocol population was defined as all randomly assigned patients who received alteplase or placebo and who were not excluded because of major protocol violations, which included, most notably, noncompliance with the current European Summary of [nejm.org]
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Amyloidosis
CONCLUSION: A 63-year-old man with renal amyloidosis and SVC syndrome secondary to HITT was successfully treated with argatroban and CDT with alteplase. [ncbi.nlm.nih.gov]
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Hunting
Finnerty J, Heaney A, Leonard C, McKnight K, Turkington J, Wroath B, Dewan B, Cotton S, Gardiner M, Saunders T, Vincent B, Sims D, Guest P, Jones E, McCormack J, Nicholl D, Savanhu J, Tongue R, Willmot M, Eveson D, Dawson S, Dickens M, Fotherby M, Hunt [ncbi.nlm.nih.gov]
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Hodgkin Lymphoma
Diseases such as chronic myelogenous leukemia, chronic lymphocytic leukemia, non-Hodgkin lymphoma, and essential thrombocythemia were included, but the complication rate and outcomes of this subset were not reported. 173 A single case report of a 24-year-old [stroke.ahajournals.org]
Respiratoric
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Respiratory Distress
CASE SUMMARY: A 62-year-old white woman admitted with respiratory distress and hypotension developed a right-sided multi-loculated pleural effusion. Thoracentesis and chest tube drainage were not successful in resolving the effusion. [ncbi.nlm.nih.gov]
Jaw & Teeth
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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]
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 [drugs.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]
Face, Head & Neck
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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]
Treatment
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]
Prognosis
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]
Etiology
•. 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]
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]
[…] 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]
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]
Epidemiology
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 (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]
Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis Of Observational Studies in Epidemiology (MOOSE) group. Jama 283, 2008–2012 (2000). 46. Hacke, W., Kaste, M. & Fieschi, C. et al. [nature.com]
and the Department of Epidemiology, Johns Hopkins University, Baltimore (M.W.). Address reprint requests to Dr. [nejm.org]
Pathophysiology
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]
DISCUSSION Although the pathophysiology and evolution of parapneumonic effusions have been well-described, 2, 3 the most effective treatment for both children and adults remains controversial. [pediatrics.aappublications.org]
Prevention
Alteplase has been shown to be effective in preventing central venous access clotting in patients on hemodialysis. [ncbi.nlm.nih.gov]
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]
Use extra care to prevent bleeding while shaving or brushing your teeth. [everydayhealth.com]
[…] al·te·plase \ ˈal-tə-ˌplās \ : 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 [merriam-webster.com]