Alteplase - Med Card PDF

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Summary

Med Card...

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ACTIVE LEARNING TEMPLATE:

Medication

STUDENT NAME _____________________________________

Alteplase AKA tPA (tissue plasminogen activator) 25 MEDICATION __________________________________________________________________________ REVIEW MODULE CHAPTER ___________ Therapeutic Class: Drug for dissolving clots / Pharmacologic Class: Thrombolytic CATEGORY CLASS ______________________________________________________________________

PURPOSE OF MEDICATION

Expected Pharmacological Action - Dissolved clots that have already formed - Clots are dissolved by conversion of plasminogen to plasmin, which destroys fibrinogen and other clotting factors

Therapeutic Use - Treat acute myocardial infarction (all three medications) - Treat massive PE (alteplase only) - Treat acute ischemic stroke (alteplase only) - Restore patency to central IV catheres (alteplase only)

Complications Bleeding for all 3 forms - Serious risk of bleeding from different sites - Internal bleeding: GI or GU tracts and cerebral bleeding - Superficial bleeding: wounds, IV catherer sites

Medication Administration IV only - Start IV infusion as soon as possible after the thrombolytic event withing 6 hrs - Administer drug as reconstituted

Contraindications/Precautions - Pregnancy Risk Category C - Contraindicated in clients who have any prior intracranial hemorrhage; known structural cerebral lesion; active internal bleeding, ischemic stroke withing 3 months - Use cautiously in clients who have severe or uncontrolled hypertension, cerebral disorders, bleeding withing 2 to 4 weeks.

Interactions Concurrent use of other medications that enhance bleeding (NSAIS's, heparin, warfarin, thrombolytics, antiplatelets) increases risk of bleeding

Nursing Interventions - Monitor for S&S of excess bleeding - Monitor neurologic checks throughout drug infusion - Protect patient from invasive procedures - Checks vital signs frequently - Report signs of bleeding - Use radial artery to draw ABG's - Monitor lab test

Client Education Evaluation of Medication Effectiveness Depending on therapeutic intent, effectiveness can be evidenced by evidence of thrombus lysis and restoration of circulation (relief of chest pain, reduction of initial ST segment injury pattern as shown on ECG 60 to 90 min after start of therapy

ACTIVE LEARNING TEMPLATES

Report: sudden severe headache, blood in urine, bloody or tarry stool, any signs of bleeding - Remain quiet and on bedrest while receiving this medication...