What are contraindications for tPA?
Contraindications
- Significant head trauma or prior stroke in the previous 3 months.
- Symptoms suggest subarachnoid hemorrhage.
- Arterial puncture at a noncompressible site in previous 7 days.
- History of previous intracranial hemorrhage.
- Intracranial neoplasm, AVM, or an aneurysm.
- Recent intracranial or intraspinal surgery.
What is contraindicated with alteplase?
Alteplase is contraindicated in patients with severe uncontrolled hypertension. In patients with systolic blood pressure of 175 mmHg or more and/or diastolic blood pressure of 110 mmHg or more, the risks of bleeding with alteplase therapy are increased and should be weighed against the potential benefits.
Why is hydralazine contraindicated in stroke?
Although hydralazine is used frequently for acute reduction of BP, its use in routine clinical practice is limited due to its selective arteriolar vasodilator effect resulting in reflex tachycardia leading to myocardial injury.
Why can’t high blood pressure patients take tPA?
Because elevated blood pressure (BP) levels may impede the effectiveness of intravenous thrombolytic treatment with tissue plasminogen activator (tPA) in patients with acute ischemic stroke (AIS), the American Heart Association and American Stroke Association advise against the use of tPA when systolic BP reaches above …
Which of the following is an absolute contraindication to the use of thrombolytic therapy?
Answer. Absolute contraindications for fibrinolytic use in STEMI include the following: Prior intracranial hemorrhage (ICH) Known structural cerebral vascular lesion.
What drugs interact with alteplase?
Which drugs or supplements interact with alteplase (TPA, Activase, Cathflo Activase)?
- warfarin (Coumadin, Jantoven),
- aspirin, and.
- nonsteroidal anti-inflammatory drugs (NSAIDs), for example, ibuprofen (Motrin, Advil), naproxen (Naprosyn, Aleve), nabumetone (Relafen), and.
When should you not give hydralazine?
Not recommended for severe hypertension or hypertensive emergencies associated with stroke or in people with cerebral edema and encephalopathy. Avoid abrupt discontinuance in people with a marked reduction in BP caused by hydralazine; reduce dosage gradually.
Is labetalol contraindicated in stroke?
Ischemic Stroke If the patient is to receive tPA, then the blood pressure should be maintained below 185/110. If there are no contraindications to the use of beta-blockers, then labetalol or esmolol would be appropriate choices. Captopril sublingually or intravenous enalapril would be acceptable alternatives.
When are thrombolytics contraindicated?
Relative Contraindications for Thrombolytic Treatment Prolonged (>10 minutes) cardiopulmonary resuscitation (CPR) or major surgery within three weeks. History of ischemic stroke.
Does tPA cause hypotension?
These events may be life threatening and may lead to death. Nausea and/or vomiting, hypotension and fever have also been reported.
Who Cannot receive thrombolytic?
Thrombolytic therapy cannot be recommended for persons excluded from the NINDS Study6 for one of the following reasons: (1) current use of oral anticoagulants or a prothrombin time greater than 15 seconds (International Normalized Ratio [INR] greater than 1.7); (2) use of heparin in the previous 48 hours and a …
What are contraindications to fibrinolytic therapy?
Contraindications to Fibrinolytic Therapy
| Absolute contraindications | Aortic dissection |
|---|---|
| Active internal bleeding (not menses) | |
| Intracranial tumor | |
| Pericarditis | |
| Relative contraindications | Blood pressure > 180/110 mm Hg after initial antihypertensive therapy |