Clot Busters

  1. Hi all,

    Just interested what thrombolytics you people are using?
    I'm in a rural area, 3 hours away from PTCA etc, so of course our first line is thrombolysis.
    We use Streptokinase (unless had before) or rpa (just changed from tpa).
    Are we years behind you guys or is this common there too?


    Greetings from sunny australia
    •  
  2. 15 Comments

  3. by   Nittlebug
    We switched to TPAse not too long ago. It's nice because it is a one time weight based bolus. Retavase required 2 boluses 30min apart. One day I had a middle aged man with a big anterior MI and I had to give the second Retavase bolus while transferring the patient to another hospital that performed unstable cardiac catheterization. We only did stable caths. Anyway, that made me a little nervous giving that outside the hospital. Even though I had 2 well trained paramedics with me.
  4. by   aus nurse
    Hi Nittlebug, Thanks for replying to my post...I thought no-one was ever gonna!!!!
    Yes very scary, to be giving in transit. We are 3-4 hours away from cath lab so do not have this dilemna.
    Good to know we are not that far behind here in Aus.

  5. by   Stormy
    Streptokinase is essentially a thing of the past for us. The only time we ever see it is when someone is transferred in from a rural area. I think it might soon be removed from formulary.

    April 1 is the target date for our conversion to TNKase. We have been using tPA. It is a weight adjusted, bolus dose drug that is simple to reconstitute and administer. We are looking forward to the change.
  6. by   JillR
    We have been using TNKase for at least 6 months now, longer than that actually, but I am not sure exactly. Easy to use, just a one time bolus.
  7. by   ceecel.dee
    We switched from tPA to TNKase a while ago as well. So very easy to use!
  8. by   kewlnurse
    We use retivase
  9. by   nimbex
    We use TNKase, so does a "feeder" hospital that sends patients to our cath lab. It is easy, but I noticed much fewer reprofusion arrythmias. Anyone else ?
  10. by   wendypants
    Here in the UK Streptokinase is still being used, unless given in the preceeding 12 months. Young anterior's or previoussly strepped patients get rTPA. Some places do primary PTCA too. However Reteplase (2 bolus injections 30mins apart) are starting to be used.

    Interesting to see what's going on around the globe
  11. by   donmurray
    I'm a psych nurse in the uk, I was given reteplase in June 2000. I almost got "ReoPro" as part of a study, but was a control.
  12. by   firestorm
    does anyone happen to know if retavase is not weight based because it simply reduces dosing error?
  13. by   ark-two
    We start + trip on heparin gtt. If blockages found during cath we keep heparin and start Intregrelin. Our strokes who are able to get reprofuse therapy gets tpa with ok after education of risks vs benefits.
  14. by   ZASHAGALKA
    Our hospital has a door to balloon in 90 min goal, so we don't use thrombolytics here. But our outlier facilities use a TNKase and turf policy.

    I think TNKase is preferred because it allows for cath right away. Because even our TNKased pts from the outlying facilities come to us with a time to balloon under 3 hours.

    We never could take them straight to cath lab on the other thrombolytics. Too juicy. But I will say this, pulling a sheath on a tenectaplased pt is a nerve-wracking experience.

    ~faith,
    Timothy.

close