What is the antidote for Activase?
There is no antidote for Activase; if a patient experiences severe bleeding during Activase therapy, immediately discontinue treatment and provide supportive therapy such as tranexamic acid or aminocaproic acid, or fresh frozen plasma or cryoprecipitate if fibrinogen levels are less than 150mg/dL. Stop all other antiplatelet or anticoagulant treatments and investigate (eg, CT brain, CT abdo/pelvis; FBC, coagulation profile [repeat every 2 hours until bleeding controlled]).
References
- Clozel JP, Banken L, Roux S. Aprotinin: an antidote for recombinant tissue-type plasminogen activator (rt-PA) active in vivo. J Am Coll Cardiol. 1990 Aug;16(2):507-10. doi: 10.1016/0735-1097(90)90612-s. PMID: 1695642.
- Reed M, Kerndt CC, Nicolas D. Alteplase. [Updated 2021 Jul 26]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK499977/
- Activase (alteplase). Activase.com. https://www.activase.com/
- Hughes RE, Tadi P, Bollu PC. TPA Therapy. [Updated 2021 Sep 29]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK482376/
Read next
Is Activase the same as tPA?
Yes, Activase is the same as tPA but technically tPA is an abbreviation for tissue plasminogen activator which is the drug class that encompasses all tissue plasminogen activators, of which there are 3 that have been FDA approved in the United States, namely Activase (generic name alteplase), Retavase (generic name reteplase), TNKase (generic name Tenecteplase). Sometimes healthcare professionals use "tPA" to refer to Activase because it was the first tissue plasminogen activator that was approved. But errors may arise because staff get confused between the abbreviation TNK and tPA. Continue reading
How is Activase (alteplase) given/administered?
How Activase is given or administered depends upon the patient’s weight and what it is being used to treat (such as a stroke, pulmonary embolism, or myocardial infarction. For example, when used to treat a heart attack (myocardial infarction), there are two Activase dose regimens, an accelerated and a 3-hour regimen, with different recommendations depending on if the patient is over 67kg or not. For the accelerated regimen, adults weighing 67 kg or less get a 15 mg IV bolus, followed by 0.75 mg/kg IV (not to exceed 50 mg) infused over 30 minutes, and then 0.5 mg/kg IV (not to exceed 35 mg) over the next 60 minutes Adults greater than or equal to 67 kg get a 15 mg IV bolus, followed by 50 mg IV infused over 30 minutes, and then 35 mg IV infused over the next 60 minutes Continue reading
Does perispinal etanercept work for stroke recovery?
There is good evidence that perispinal administration of etanercept works extremely well for stroke recovery, with the publication of the first RCT in 2019 that supported thousands of individual case reports of a beneficial effect. Improvements in chronic post-stroke symptoms with etanercept is usually rapid and long-lasting. Perispinal etanercept was first developed as a treatment for poststroke symptoms by Dr. Edward Tobinick, in 2010. Continue reading
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