Questions and Answers
What is the classification of Tenecteplase?
What are the indications for using Tenecteplase?
STEMI when following fibrinolytic pathway
What is one contraindication for Tenecteplase?
Known severe allergy
Which of the following are cautions for administering Tenecteplase? (Select all that apply)
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What is the pharmacodynamics of Tenecteplase?
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The metabolism of Tenecteplase occurs in the ______.
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How is the dose of Tenecteplase determined?
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What is the onset time for Tenecteplase?
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What is the duration of action for Tenecteplase?
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What category does Tenecteplase fall under in obstetrics?
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What is a common adverse effect of Tenecteplase?
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Are there known interactions for Tenecteplase?
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Study Notes
Tenecteplase Overview
- Tenecteplase is classified as a fibrinolytic/thrombolytic agent, primarily used to dissolve blood clots.
Indications
- Administered in STEMI (ST-Elevation Myocardial Infarction) cases following the fibrinolytic pathway.
Contraindications
- Known severe allergy to Tenecteplase.
Cautions
- Assess for clinically significant bleeding or recent CPR (>10 minutes).
- Avoid in patients with non-compressible vascular punctures in the past 24 hours.
- Caution if there's a history of internal bleeding within the last six weeks.
- Avoid administration within six weeks after lumbar puncture or epidural insertion.
- History of transient ischemic attack (TIA) in the last three months is a caution.
- Known bleeding disorders and anticoagulant usage require careful consideration.
- Monitor for high blood pressure: systolic BP >180 mmHg or diastolic BP >110 mmHg.
- Pregnancy status is crucial; avoid if within 12 hours of delivery or known to be pregnant.
- Consider frailty, dependency for activities of daily living (ADLs), and life expectancy significantly shortened by other diseases.
- Suspected aortic dissection, recent major surgery, or significant trauma within six weeks must be evaluated.
- Precautions for intracranial surgery within the last six months and any history of ischemic stroke or intracerebral hemorrhage.
- Known cerebral aneurysms, arteriovenous malformations, or tumors also require caution.
Pharmacodynamics
- Functions as a fibrin-specific tissue-plasminogen activator, binding to fibrin-rich clots, converting plasminogen to plasmin, which degrades the fibrin matrix of thrombi, aiding in clot resolution.
Pharmacokinetics
- Metabolized by the liver, with no significant adverse effects noted from liver impairment during acute administration.
Dose and Dilution
- Dosage is calculated based on age and estimated weight.
- Dilution involves dissolving the powder in the provided syringe, discarding excess drug into the ampoule before administration.
- Administer as an undiluted IV bolus using a running IV line.
Onset and Duration
- Onset of action is typically between 5-10 minutes.
- The therapeutic duration lasts approximately 2-6 hours.
Obstetrics
- Classified as Category C.
- Significant bleeding risk during pregnancy or within two weeks of birth, even though STEMI risk in these populations is low.
- Clinical consultation is recommended prior to administration in these cases.
- Safe to administer while breastfeeding, but patients should be advised to halt breastfeeding and seek further medical guidance.
Adverse Effects
- Common adverse effects include superficial bleeding (e.g., epistaxis, bruising, bleeding from IV sites).
- Possible dysrhythmias typically occur if coronary artery reperfusion is achieved, with accelerated idioventricular rhythm being the most common, requiring no specific treatment.
Interactions
- No significant drug interactions reported.
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Description
Test your knowledge with these flashcards on Tenecteplase, a fibrinolytic agent. Each card covers important aspects such as definitions, indications, contraindications, and cautions related to its use in clinical settings. Perfect for medical students and professionals alike.
