Q: All of the following should be confirmed prior to administration of alteplase in acute stroke except?
A) The time window is met
B) Eligibility criteria is fulfilled
C) Hypoglycemia is ruled out
D) Two intravenous lines, preferably 2 large bores, are placed
E) Ideal body weight is measured
Answer: E
Besides all the 'checklist' marked for the administration of alteplase, there are two other essentials that should be checked
1) A dedicated intravenous line is required for alteplase.
2) The dose should be calculated of actual body weight.
The dose of alteplase dose is 0.9 mg/kg, with a maximum dose of 90 mg, 10% of which is given as an upfront bolus and the remainder is infused over next hour.
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Reference:
Michaels AD, Spinler SA, Leeper B, et al. Medication errors in acute cardiovascular and stroke patients: a scientific statement from the American Heart Association. Circulation 2010; 121:1664.
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