N213 - Week 5 Medications (EXAM 2) 78
Questions and Correct Answers, 100%.
Updated Fall 2024/2025.
What class of medication is Alteplase? How is it administered?
Thrombolytics
IV (must have its OWN IV line)
What are THREE primary uses for Alteplase?
Lysis of thrombi for...
1. Acute MI
2. Acute ischemic stroke
3. Acute massive PE
***most effective first 4-6 hr***
How does Alteplase work?
Directly converts plasminogen to plasmin, which then degrades clot-bound fibrin.
What is a SE/AE of Alteplase?
- Intracranial hemorrhage
- Generalized bleeding
What are drug-drug interactions when taking Alteplase?
1. Tranexamic acid (antifibrinolytic agent) may decrease effect of Alteplase
2. Antiplatelet agents ↑ risk of bleeding, although these agents are frequently used together or in
sequence.
Ex.
- Aspirin
- NSAIDs
- Warfarin
- Heparin
, What herbal remedies cannot be used with Alteplace?
What are contraindications to administering Alteplase?
- Ischemic stroke within past 3 months except ischemic stroke within 4.5 hr
- Severe uncontrolled HTN unresponsive to EM therapy
- Current use of anticoagulants in therapeutic doses **(INR 2-3 or greater)**
Nursing assessments for Alteplase?
- Assess for bleeding every 15 min during the 1st hr of therapy, every 15-30 min during the next 8 hr,
and at least every 4 hr for the duration of therapy
- Assess neuro status (for potential intracranial bleeding)
What is the antidote for Alteplase?
- Aminocaproic acid (Amicar)
What class of medication is Tenecteplase? How does it work?
Thrombolytic
Promote conversion of plasminogen to plasmin = An enzyme that degrades the fibrin matrix of thrombi.
What is Tenecteplase used for?
Approved only for acute MI
How is Tenecteplase administered?
IV (must have its own IV line)
How is Tenecteplase similar to Alteplase?
- Same MOA
- Same SE
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