Tenecteplase

Question 1

Drug class

Answer 1

Fibrinolytic

Question 2

Pharmacology

Answer 2

Thrombolytic agent which combines with the fibrin component of the thrombus & converts thrombus-bound plasminogen to plasmin. This degrades the fibrin matrix of the thrombus

Question 3

Metabolism

Answer 3

Hepatic

Question 4

Indications

Answer 4

Pts with STEMI who meet the criteria for pre-hospitsl tenecteplase (as per CARC)

Question 5

Contraindications

Answer 5

• <18 or ≥75yrs
• Uncontrolled hypertension (SBP>180 AND/OR DBP>100 at any stage during acute episode)
• Allergy and/or adverse drug reaction to any of:
- tenecteplase, enoxaparin or clopidogrel
• LBBB
• Current Hx of thrombocytopenia
• Acute TB (tuberculosis)
• Ischaemic stroke or TIA within 3 months
• Hx significant closed head or facial trauma within last 3 months
• Suspected aortic dissection (including new neuralgia)
• Hx major trauma or surgery (incl. laser eye) within last 6wks
• Internal bleeding within last 6wks (excl. menses)
• Bleeding or clotting disorder
• Current use of anticoagulants i.e.Warfarin
• Non-compressible vascular punctures
• >10mins CPR
• Pregnancy or delivered in last 2 wks
• Hx serious systemic disease (i.e. CA, kid/liv dis)
• Aged care resident req. significant assistance
• AMI in the setting of trauma

Question 6

Precautions

Answer 6

Nil

Question 7

Side effects

Answer 7

• Haemorrhage

* Dysrrhythmias

Question 8

Presentation

Answer 8

50mg (10,000 IU) injection (powder & solvent)

Question 9

Route

Onset

Duration

Answer 9

IV

15min

Several hours

Question 10

Adult dosages

Answer 10

Pts with STEMI who meet the criteria for pre-hosp tenecteplase

▪︎ IV
    <60kg - 30mg - 6ml
    ≥60-<70kg - 35mg - 7ml
    ≥70-<80kg - 40mg - 8ml
    ≥80-<90 - 45mg - 9ml
    ≥90 - 50mg - 10ml