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Frequency, Risk Factors, and Clinical Significance of Incorrect Dose of Alteplase Due to Weight Estimation in Acute Ischemic Stroke Patients: A Single-Center Retrospective Study
Stroke is a clinical emergency requiring urgent recombinant tissue-type plasminogen activator treatment in eligible patients. The dosage of thrombolytic agent (alteplase) is weight dependent. However, many patients receive thrombolytic therapy based on weight estimation. Here, we assess the frequency of incorrect thrombolytic therapy dose as a result of weight estimation and evaluate the short-term safety and efficacy of alteplase misdose. Of 237 patients, weight was estimated in 147 (62%), of which 33 patients (22.4%) were treated with an erroneous dose of alteplase. An incorrect dose was associated with neither poor outc...
Source: Journal of Neuroscience Nursing - September 9, 2019 Category: Neuroscience Tags: Article Source Type: research

Symptomatic Intracerebral Hemorrhage after Intravenous Thrombolysis: Predictive Factors and Validation of Prediction Models
Objective: Thrombolytic therapy with intravenous alteplase (IV-rtPA) has a known risk of symptomatic intracerebral hemorrhage (sICH). We aim to identify factors with a significant association with the development of sICH post-IV-rtPA. We also aim to perform an external validation of sICH predicting scores in our patient population. Material and Methods: We performed a retrospective chart review of patients who received IV-rtPA at our tertiary care hospital. We excluded patients who underwent mechanical thrombectomy.
Source: Journal of Stroke and Cerebrovascular Diseases - September 5, 2019 Category: Neurology Authors: Taha Nisar, Rajanigandhi Hanumanthu, Priyank Khandelwal Source Type: research

The safety and efficacy of tPA intravenous thrombolysis for treating acute ischemic stroke patients with a history of cerebral hemorrhage.
Abstract Alteplase (tPA) intravenous thrombolysis is an effective treatment for acute ischemic stroke (AIS) when administered within 4.5 h of initial stroke symptoms. Here, its safety and efficacy were evaluated among AIS patients with a previous history of cerebral hemorrhage. Patients who arrived at the hospital within 4.5 h of initial stroke symptoms and who were treated with tPA intravenous thrombolysis or conventional therapies were analyzed. The 90-day modified Rankin scale (90-d mRS) was used alongside mortality and incidence of symptomatic intracerebral hemorrhage (SICH) rates to evaluate the curative effe...
Source: Braz J Med Biol Res - January 24, 2019 Category: Research Authors: Zhao GJ, Wang ZR, Lin FZ, Cui YS, Xu SL Tags: Braz J Med Biol Res Source Type: research

Treatment With Intravenous Alteplase for Acute Ischemic Stroke After Reversal of Dabigatran With Idarucizumab: A Case Study
Treatment options for anticoagulated patients presenting with ischemic stroke are limited. Off-label use of idarucizumab to rapidly reverse the anticoagulant effect of dabigatran may ensure eligibility for thrombolytic therapy with alteplase. This case describes a 77-year-old white male who presented to the hospital 89 minutes after sudden onset of right-sided hemiparesis, dysarthria, and facial palsy. Significant history included atrial fibrillation and previous right-sided cortical stroke. Medication reconciliation revealed he was taking dabigatran 150 mg twice a day, with the last dose being 179 minutes before presentat...
Source: Journal of Neuroscience Nursing - January 8, 2019 Category: Neuroscience Tags: Case Study Source Type: research

Complications associated with recombinant tissue plasminogen activator therapy for acute ischaemic stroke.
Abstract Intravenous recombinant human tissue plasminogen activato (rtPA, formulated as alteplase) is the primary therapy for acute ischaemic stroke by breaking down a clot of an occluded vessel. There are several randomised controlled trials and observational studies that support the use of rtPA to improve functional outcome following acute ischaemic stroke. However, thrombolytic therapy with rtPA can be associated with a number of complications. Many of the rtPA-related complications result from its thrombolytic action including bleeding (intracerebral and systemic haemorrhage), reperfusion injury with oedema, a...
Source: CNS and Neurological Disorders Drug Targets - February 4, 2013 Category: Drugs & Pharmacology Authors: Balami JS, Sutherland BA, Buchan AM Tags: CNS Neurol Disord Drug Targets Source Type: research