Indications for TNKASE:
To reduce mortality associated with acute myocardial infarction (AMI).
Start treatment soon after onset of AMI symptoms. Give as single IV bolus over 5 seconds. <60kg: 30mg; ≥60kg–<70kg: 35mg; ≥70kg–<80kg: 40mg; ≥80kg–<90kg: 45mg; ≥90kg: 50mg. Max: 50mg.
Active internal bleeding. History of cerebrovascular accident. Intracranial or intraspinal surgery or trauma within 2 months. Intracranial neoplasm, arteriovenous malformation, or aneurysm. Bleeding diathesis. Severe uncontrolled hypertension.
Avoid noncompressible arterial puncture, internal jugular and subclavian venous puncture, IM injections and nonessential handling of patient during treatment. Increased bleeding risk at puncture sites; minimize arterial and venous punctures. Increased risk of complications with recent major surgery, cerebrovascular disease, GI or GU bleeding, recent trauma, hypertension (systolic BP ≥180mm Hg and/or diastolic BP ≥110mm Hg), acute pericarditis, subacute bacterial endocarditis, hemostatic defects, hepatic dysfunction, pregnancy, hemorrhagic ophthalmic conditions, septic thrombophlebitis, elderly. Increased risk of thromboembolic events in those with left heart thrombus (eg, mitral stenosis, A-fib). Pregnancy. Nursing mothers.
Tissue plasminogen activator (tPA).
Increased bleeding risk with heparin, vitamin K antagonists, aspirin, dipyridamole, GP IIb/IIIa inhibitors. May interfere with coagulation tests.
Bleeding (may be serious), cardiogenic shock, arrhythmias, AV block, pulmonary edema, heart failure, cardiac arrest, recurrent MI, myocardial rupture, cardiac tamponade, pericarditis, pericardial effusion, mitral regurgitation, thromboembolism, electromechanical dissociation, nausea, vomiting, hypotension, fever; hypersensitivity reactions (monitor), cholesterol embolism.
Vial—1 (w. diluent, supplies)