thrombolytics (NOT COMPLETE)

Question 1

simple explanation of tenecteplase role

Answer 1

accelerates the breakdown of clots

Question 2

Heparin role simple explanation

Answer 2

short acting anticoagulant

Question 3

enoxaparin basic role

Answer 3

long acting anticoagulant

Question 4

clopidogrel basic role

Answer 4

antiplatelet

Question 5

tenecteplase preparation

Answer 5

Glass ampoule containing 50 mg of tenecteplase, in powder form with a pre-filled syringe containing 10 ml of sterile water.

Question 6

what is tenecteplase

Answer 6

fibrinolytic that accelerates the breakdown of blood clots

Question 7

Tenecteplase MOA

Answer 7

Tenecteplase accelerates the breakdown of clots by stimulating TPA (tissue plasminogen activator, an enzyme) to facilitate the increased conversion of plasminogen to plasmin, resulting in a breakdown of fibrin ( the mesh casing of vessels).

Question 8

ILS indcation of tenectplase

Answer 8

STEMI when following the fibrinolytic pathway.

Question 9

contradictions of tenectplase

Answer 9

allergy

Question 10

cautions of tenectaplse

Answer 10

Clinically significant bleeding.
More than ten minutes of CPR.
Non-compressible vascular puncture within the last 24 hours.
Internal bleeding within the last six weeks.
Lumbar puncture or epidural insertion within the last six weeks.
TIA within the last three months.
Known bleeding disorder.
Taking an anticoagulant. If the patient is taking warfarin document their last known INR result if possible.
Systolic BP greater than 180 mmHg or diastolic BP greater than 110 mmHg.
Known to be pregnant or less than two weeks postpartum.
Time of onset of symptoms was greater than 12 hours ago.
Dependent on others for activities of daily living.
Another disease significantly shortens their life expectancy.
Very frail.
Suspected aortic dissection.
Major surgery, major trauma or severe brain injury within the last six weeks.
Intracranial surgery within the last six months.
Ischaemic stroke within the last six months.
Previous intracerebral haemorrhage.
Known cerebral aneurysm, arteriovenous malformation or tumour.

Question 11

tenectaplase and pregency?

Answer 11

seek clinical advise

Question 12

administration of tenectplase

Answer 12

Follow weight based medication chart
Dissolve the powder using the syringe within the kit.
Carefully discard unwanted drug from the syringe, preferably into the ampoule before administration, ensuring the correct dose remains in the syringe.
If an error is made in discarding unwanted drug and the correct dose cannot be drawn up, administer the remaining drug, document this well, and notify the receiving clinician.

Administer undiluted as an IV bolus, preferably into a running IV line.

Question 13

advese effects of tenectaplase

Answer 13

Bleeding. Tenecteplase commonly causes superficial bleeding, including epistaxis, bruising and bleeding from IV sites.
Dysrhythmia. It is common for dysrhythmia to occur if the coronary artery reperfuses. Most commonly the rhythm is accelerated idioventricular rhythm (AIVR) which does not require specific treatment. Other dysrhythmias should be treated using the appropriate section.

Question 14

onset of tenectplase

Answer 14

5-10 minutes

Question 15

duration of tenectplasse

Answer 15

2-6 hours

Question 16

interactions of tenectplase

Answer 16

nil

Question 17

enoxaparin preparation

Answer 17

Pre-filled syringe containing 100 mg in 1 ml.

Question 18

what is enoxaparin

Answer 18

low molecular weight heparin (LMWH) anticoagulant.

Question 19

enoxaparin mechanism

Answer 19

Enoxaparin increases the activity of antithrombin lll (a naturally occurring anticoagulant, inhibits clotting ) causing inhibition of multiple coagulation factors including clotting factor II (thrombin) and factor 10 Xa (which makes fibrin). thrombin is unable to convert fibrinogen to fibrin and form a clot.

Question 20

ILS enoxaparin indication

Answer 20

STEMI in conjunction with fibrinolytic therapy.

Question 21

contraindction of enoxaparin

Answer 21

allergy

Question 22

cautions of enoxaparin

Answer 22

Clinically significant bleeding. Enoxaparin will increase bleeding.
At risk of bleeding. If there are any cautions present within the fibrinolytic therapy checklist, personnel must seek clinical advice or discuss with the STEMI coordinator prior to administration.
Pregnancy.

Question 23

admin of eneoxaparin

Answer 23

Administer subcutaneously into the abdominal wall.
There is no need to sterilise the skin at the site of injection unless the skin is visibly contaminated.
Discard unwanted drug from the syringe before administration.
If an error is made in discarding unwanted drug volume and the dose remaining in the syringe is less than planned, administer the remaining dose.

Question 24

adverse effects of eneoxparin

Answer 24

increased bleeding