Alteplase
(ACTIVASE, TPA) |
| Usual
Diluents |
| NS, D5W |
| Standard
Dilutions [Amount of drug]
[Infusion volume] [Infusion rate] |
Note: SW
without preservative
[50 mg vial] [50 ml - SW] [UD]
[100 mg vial] [100 ml - SW ] [UD]
Peripheral arterial occlusive
disease: Continuous infusion of alteplase:
0.5 to 2 mg/hr x 6 to 72 hours depending on location.
Preparation: Dilute alteplase with sterile water
as above, then further dilute with NS to produce one of
the following concentrations below:
Concentration (0.1 mg/ml)
[25 mg] [250ml]
[50 mg] [500 ml]
Concentration (0.2 mg/ml)
[50 mg] [250ml]
Alternatives:
Concentration (0.025 mg/ml)
[12.5 mg] [500ml]
Concentration (0.05 mg/ml)
[25 mg] [500ml]
|
|
| Stability
/ Miscellaneous |
EXP: 8 hours (RT).
Prepare just before use. Results in concentration of 1 mg/ml. May be
infused at this concentration or may dilute further with equal volume of
normal saline or D5W (0.5 mg/ml). Dosing: Acute MI: (2
protocols)-
(1) (Preferred) Accelerated infusion: for patients > 65kg: 15
mg IV bolus f/b 50mg over next 30min, and the remaining 35mg (100mg
total) infused over the next 60 min. Patients <65kg: 15 mg bolus,
then 0.75 mg/kg (max 50 mg) over 30 minutes, then 0.5 mg/kg (max 35 mg)
over next 60 minutes.
(2) 3-hour infusion (may be less effective): In 1st hour, 60 mg
is administered (of which 6-10mg is administered ivpush in first 1-2
minutes), followed by 20 mg/hr x 2 hours. (100mg total). For
patients <65 kg: administer 1.25 mg/kg in the same manner over 3
hours.
Pulmonary embolism: 100 mg over 2 hours.
Stroke:
(Give within first 3 hours): 0.9 mg/kg (max 90mg)-10% of dose given
ivpush, followed by a continuous infusion over 1 hour. |
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