Page 49 - RxExam's Naplex Theory Review Part-1

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Dose Special Notes

Alteplase b). For patients weighing ≤ 2). In acute ischemic stroke, neither the incidence of
(Injection) 67 kg, the recommended intracranial hemorrhage nor the benefits of therapy are
dose is administered as a 15 known in patients treated with Alteplase (Activase) more
mg intravenous bolus, than 3 hours after the onset of symptoms. Therefore,
followed by 0.75 mg/kg treatment of patients with acute ischemic stroke more
infused over the next 30 than 3 hours after symptom onset is not recommended.
minutes not to exceed 50 The total dose for the treatment of acute ischemic stroke
mg, and then 0.50 mg/kg should NOT exceed 90 mg.
over the next 60 minutes not
to exceed 35 mg. 3). A dose of 150 mg of Alteplase should not be used for
the treatment of acute myocardial infarction because it
2. Ischemic Stroke: has been associated with an increase in intracranial
0.9 mg/kg (NOT TO exceed bleeding.
90 mg total dose) infused
over 60 min. 10% of this total 4). The total dose for treatment of acute ischemic stroke
dose is given as an IV bolus should not exceed 90 mg.
over 1 min.
5). It is important that Alteplase (Activase) be
3). PE: 100 mg via IV infusion reconstituted only with Sterile Water for Injection, USP,
over 2 hours. without preservatives.

Reteplase It is administered as 10 +10 1). Reteplase (Retavase) is a recombinant plasminogen
(Injection) unit double-bolus injection. activator which catalyzes the cleavage of endogenous
Two 10 unit bolus injections plasminogen to generate plasmin.
are required for a complete
treatment. Each bolus is 2). Reteplase (Retavase) is indicated for the treatment of
administered as an intravenous myocardial infarction.
injection over 2 minutes. The
second bolus is given 30 3). Heparin and Reteplase (Retavase) are incompatible
minutes after initiation of the when combined in solution. Do not administer heparin and
first bolus injection. Each Reteplase (Retavase) simultaneously in the same
bolus injection should be intravenous line.
given via an intravenous line
in which no other medication
is being simultaneously
injected or infused.

Tenecteplase It is for intravenous 1). Tenecteplase (TNKase) is a modified form of human
(Injection) administration only. The tissue plasminogen activator (tPA) that binds to fibrin and
recommended total dose converts plasminogen to plasmin.
should not exceed 50 mg and
is based upon patient weight. 2). In the presence of fibrin, in vitro studies demonstrate
A single bolus dose should be that Tenecteplase (TNKase) conversion of plasminogen to
administered over 5 seconds plasmin is increased relative to its conversion in the
based on patient weight. absence of fibrin.

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