Alteplase

Question 1

Therapeutic Classification

Answer 1

None

Question 2

Pharmacologic Classification

Answer 2

Thrombolytic/fibrinolytic

Question 3

Mechanism of Action

Answer 3

Converts plasminogen to plasmin, which then dissolves fibrin clots. Also, degrades procoagulant factor V and VIII and lowers circulating amount of fibrinogen and plasminogen.

Question 4

Indications

Answer 4

• Thrombotic CVA

- off-label use to restore IV catheter patency.

Question 5

Contraindications

Answer 5

• History of CVA in last 3 months
• Recent trauma/surgery
• Active bleeding
• Severe HTN
• Intracranial neoplasm
• AV malformation

Question 6

Drug interactions with anticoagulants, thrombolytic agents, antiplatelet agents, and NSAIDs?

Answer 6

Increased risk of bleeding

Question 7

Adverse Effects

Answer 7

• *Angioedema
• *intracranial bleeding
• bleeding
• transient dysrhythmias.

Question 8

pregnancy category?

Answer 8

Pregnancy Category C

Question 9

Nursing Considerations

Answer 9

• Complete health history
• Assess for bleeding
• Avoid invasive procedures
• Keep patient in bed
• Check vital signs frequently
• Apply pressure to puncture sites x 30 minutes

Question 10

Patient & Family Teaching

Answer 10

• Remain quiet and on bed rest when receiving this medication
• Report bleeding