According to NINDS, 30% of alteplase recipients have a "less disabled final outcome," including 12% with little or no disability three months after an ischemic stroke. Poor outcomes are common after a stroke even when alteplase is administered. "We're one of the largest users of t-PA on the East Coast right now," he said.Īccording to the National Institute of Neurological Disorders and Stroke (NINDS), about 5% of patients nationwide receive reperfusion therapy after a stroke, and only 40% of those are treated within "a useful time frame." Bridgeman said having the recommendation in the guideline may increase clinicians' comfort level with the practice.īut he said the neurologists at RWJUH, a Joint Commission-certified primary stroke center, aren't worried about the labeling issue.īridgeman said 98 of the approximately 700 patients evaluated last year by RWJUH's stroke team, or 14%, were treated with alteplase.
The administration of alteplase beyond 3 hours after symptom onset is an off-label use of the drug. It's definitely going to expand the number of patients that can be treated," said Patrick Bridgeman, emergency department pharmacist at 600-bed Robert Wood Johnson University Hospital (RWJUH) in New Brunswick, New Jersey.ĪHA and ASA initially made the recommendation in a 2009 advisory bulletin, but this is the first time the expanded window has been included in the groups' official guideline, which was last updated in 2007.
Antidote for alteplase Activator#
Further gains, according to AHA and ASA, require a comprehensive approach to caring for patients in the immediate aftermath of a stroke.Ī major medication-related recommendation in the guideline is the option to begin therapy with alteplase, a recombinant tissue-type plasminogen activator (t-PA), up to 4.5 hours after the onset of stroke symptoms in certain patients instead of limiting the therapy to within 3 hours after the stroke. National Pharmacy Preceptors ConferenceĪ revised American Heart Association and American Stroke Association (AHA–ASA) guideline on the early management of ischemic stroke seeks to build on recent gains in reducing disability and death from stroke.Īccording to the guideline, stroke in 2008 was the fourth-leading cause of death in the United States-an improvement from previous years, when the disease ranked third.Midyear Clinical Meeting and Exhibition.Pharmacy Technician Membership and Accreditation.Certified Pharmacy Executive Leader (CPEL).
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