II. Dose
-
Myocardial Infarction
- Bolus: 15 mg IV THEN
- Next: 0.75 mg/kg (max 50 mg) over 30 minutes THEN
- Next: 0.5 mg/kg (max 35 mg) over next 60 minutes
- Administer adjunctive Heparin concurrently
- See Thrombolysis
- Acute Ischemic Cerebrovascular Accident
- Calculate total dose: 0.9 mg/kg (max 90 mg)
- Bolus: Give 10% total dose as IV bolus over 1 minute
- Next: Give remainder of total dose over 60 minutes
- Acute Massive Pulmonary Embolus
III. Disadvantages (compared with other Thrombolytics)
- Cost: $1200
- Increased bleeding risk
- 3-4% greater risk of bleeding in older than age 75
- Re-occludes earlier than other Thrombolytics
- Needs Heparin concurrently and afterward
IV. Advantages (compared with other Thrombolytics)
- Probably reperfuses arteries earlier
- Superior in large, anterior Myocardial Infarctions