ALTEPLASE
(TPA; tissue plasminogen activator; Activase rTPA; Cathflo)Standard Prescription
alteplase __mL instilled into each blocked lumen
alteplase __mg/kg/hr IV infusion x __hours
alteplase 4 mg/4 mL instilled into chest tube Q24H for 3 doses
Dosages
For Blocked Central Line:
1 mg/mL concentration is used.
Instill into each blocked lumen of CVC or implanted port (volume is dependent upon volume of the device in situ).
-Instill 110% of catheter lumen volume (if known). Maximum 2 mL
-If catheter lumen volume is unknown, instill 1 mL (weight < 30 kg) or 2 mL (weight ≥ 30 kg)
Dwell time is 2 hrs.
Systemic Thrombolytic Therapy:
To be given in intensive care areas only.
0.5 mg/kg/hr IV x 6 hrs
Parapneumonic effusion :
4 mg/4 mL instilled into chest tube Q24H for total of 3 doses (if platelets >50,000)
1 mg/mL concentration is used.
Instill into each blocked lumen of CVC or implanted port (volume is dependent upon volume of the device in situ).
-Instill 110% of catheter lumen volume (if known). Maximum 2 mL
-If catheter lumen volume is unknown, instill 1 mL (weight < 30 kg) or 2 mL (weight ≥ 30 kg)
Dwell time is 2 hrs.
Systemic Thrombolytic Therapy:
To be given in intensive care areas only.
0.5 mg/kg/hr IV x 6 hrs
Parapneumonic effusion :
4 mg/4 mL instilled into chest tube Q24H for total of 3 doses (if platelets >50,000)
Mechanism of Action
Thrombolytic; recombinant enzyme which catalyzes conversion of plasminogen to plasmin
Forms Supplied
Injection: 50 mg/vial
Cathflo: 1 mg/mL (2 mL)
Cathflo: 1 mg/mL (2 mL)
Comments
Consult to hematology service is mandatory for systemic thrombolysis.
For systemic therapy monitor fibrinogen (maintain > 1 g/L), PT, APTT, platelets (maintain >100,000)
Risk of bleeding increases with increased duration of infusion.
For detailed information refer to C&W Policies on:
Clearing blocked central lines;
Central Venous Catheter Occlusion;
Systemic Thrombolytic Therapy;
Parapneumonic effusions.
For systemic therapy monitor fibrinogen (maintain > 1 g/L), PT, APTT, platelets (maintain >100,000)
Risk of bleeding increases with increased duration of infusion.
For detailed information refer to C&W Policies on:
Clearing blocked central lines;
Central Venous Catheter Occlusion;
Systemic Thrombolytic Therapy;
Parapneumonic effusions.
References
Ref. 90, 149
Last Edited
2019-01-24 15:38:26