Thrombolysis

Question 1

Thrombolysis agent

Answer 1

Tenecteplase (weight base) 0.5mg/kg bolus. >60kg: 50mg, <60kg: 30mg
age >75 0.25mg/kg bolus

Question 2

Thrombolysis Absolute CI

Answer 2

Aortic Dissection
Significant head/facial trauma in 3/12
Previous ICH
Ischaemic CVA <3/12
Known Malignant Intracerebral neoplasm
Acute Pericarditis

Question 3

Thrombolysis Relative CI

Answer 3

Dementia
Traumatic/prolong CPR>10min
Anticoagulation INR>1.3
HTN SBP >180, DBP >110
Surgery: Major <3/52
Malignancy
Pregnancy

Question 4

Advantages of PCI vs Thrombolysis

Answer 4

• Reduce hemorrhagic complications
• Reduced reinfarction rate
• Increase degree of arterial opening
• Greater survival in cardiogenic shock.
• Not C/I in most of population

Question 5

Side effects

Answer 5

• Failure to re-perfuse -35%
• Reperfusion arrythmia (AIVR,VT,VF)
• Hemorrhagic stroke (2%)
• Hypotension (10-20%)
• Anaphylaxis 5%