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Names / Class
Mechanism of Action
Increased formation of plasmin which breaks down the fibrin matrix of a clot.
Onset of Action
- <5 minutes
- 13 - 16 minutes
- Acute coronary syndrome
- Acute MI
- Prior intercranial hemorrhage
- Structural cerebral vascular lesion
- Malignant intercranial neoplasm
- Ischemic stroke within 3 mos EXCEPT within 3 hours
- Aortic dissection
- Significant closed head/facial trauma within 3 mos
Benefits must outweigh Risks:
- Hx of chronic, severe, poorly controlled HTN
- Severe uncontrolled HTN on presentation (SBP >180 mmHg or DBP >110 mmHg).
- Hx of prior ischemic stroke >3 mos, dementia, or known intracranial pathology.
- Traumatic or prolonged (>10 min) CPR or major surgery (<3 weeks).
- Recent internal bleeding (past 2 - 4 weeks)
- Noncompressible vascular punctures
- Active peptic ulcer
- Current use of anticoagulants
- Anaphylaxis (rare)
- Resuscitative drugs & equipment should be readily available
- Antiarrythmic meds should be available
- Allergic Reactions
- 10 units IV over 2 minutes.
- Repeat 10 units IV over 2 minutes in 30 minutes.
- (20 units total)
Routes / How Supplied
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