160 Alteplase (Activase)

Question 1

Therapeutic classification

Answer 1

None

Question 2

Pharmacologic classification

Answer 2

thrombolytic/fibinolytic

Question 3

Mechanism of action

Answer 3

converts plasminogen to plasmin, which then disolves fibrin clots, degrades procoagulant factors V and VIII and lobers circulating amount of fibrinogen and plasminogen

Question 4

indications

Answer 4

Thrombotic CVA, Off-label use to restore IV cathetor potency

Question 5

precautions

Answer 5

none

Question 6

contraindications

Answer 6

History of CVA in last 3 months, recent trauma/surgery, active bleeding, severe HTN, intracranial neoplasm, AV malformation

Question 7

drug interactions

Answer 7

Increased risk of bleeding with anticoagulants, thrombolytic agents, antiplatelet agents, and NSAIDs; enhanced hepatic degradation with IV nitroglyceryn

Question 8

pregnancy category

Answer 8

C

Question 9

adverse effects

Answer 9

bleeding, transient dysrhythmias

Question 10

nursing considerations

Answer 10

health HX, assess for bleeding, avoid invasive procedures, keep patient in bed, check vital signs frequently, apply pressure to puncture sites for 30 min.

Question 11

teaching

Answer 11

remain on bed rest when receiving meds, report bleeding

Question 12

Antidote

Answer 12

none

Question 13

common route

Answer 13

IV ?