Activase, also known as alteplase, is a powerful medication used in the treatment of acute ischemic stroke (AIS). Administering Activase promptly and correctly is crucial in managing AIS and minimizing potential long-term complications. Here, we will discuss the proper administration of Activase, including the dosage, route of administration, and essential considerations.
Activase is typically administered intravenously at a dose of 0.9 mg/kg (maximum dose 90 mg), with 10% of the total dose given as an initial bolus over 1 minute and the remaining 90% infused over 60 minutes. It is important to calculate the accurate dose based on the patient’s weight and ensure that the correct syringe and infusion pump are used to prevent dosing errors.
The medication should be reconstituted as per the manufacturer’s instructions using the provided sterile water. After reconstitution, Activase should be diluted in sterile diluent (usually normal saline) to achieve a concentration suitable for intravenous infusion. Care should be taken to maintain strict aseptic technique during the reconstitution and dilution process to prevent contamination.
Intravenous access is essential for the administration of Activase. A large-bore catheter or central line is preferred to ensure rapid and consistent delivery of the medication. The infusion site should be closely monitored for signs of infiltration or phlebitis, and the infusion should be promptly discontinued if any such complications arise.
It is crucial to perform a thorough assessment of the patient’s medical history, including a review of any recent surgeries, injuries, or other factors that may increase the risk of bleeding. Activase is contraindicated in patients with active internal bleeding, recent trauma or surgery, or a history of intracranial hemorrhage. Additionally, caution should be exercised in patients with a recent history of stroke, uncontrolled hypertension, or other conditions that may increase the risk of bleeding complications.
Close monitoring of the patient’s vital signs, including blood pressure, heart rate, and respiratory status, is essential during and after the administration of Activase. Any signs of hypersensitivity reactions, such as rash, itching, or difficulty breathing, should be promptly reported and managed accordingly.
After the completion of Activase infusion, the patient should be closely monitored for signs of bleeding, including neurological deterioration, changes in mental status, or other clinical indicators of hemorrhage. It is essential to have contingency plans in place for managing any bleeding complications that may arise, including the availability of blood products, reversal agents, and access to advanced medical interventions if needed.
In conclusion, the proper administration of Activase for AIS is a critical aspect of stroke management. Healthcare providers should be familiar with the recommended dosage, reconstitution, and dilution procedures, as well as the contraindications and potential adverse effects of the medication. Strict adherence to established protocols, continuous monitoring of the patient, and readiness to manage potential complications are essential components of the safe and effective administration of Activase for AIS.
