Podcasts about Alteplase

Send us a textDr. Laiya Carayannopoulos & Dr. Mike Fralick connect to bring you another crossover episode, this time covering new studies on therapies for bronchiectasis and posterior circulation stroke. Take a listen and let us know what you think! Do you ever feel like you can't get ahead of charting? Freed AI has an AI driven scribe for you! You can try Freed for free right now by going to getfreed.ai. Listeners can use the INTERN50 code for $50 off their first month!Support the show

Send us a textWelcome back Rounds Table Listeners! We are back today with our Classic Rapid Fire Podcast. This week, Dr. Mike Fralick and special guest Dr. Laiya Carayannopoulos from the Intern at Work Podcast and our Medicine Pods collaboration discuss two recent papers: the use of brensocatib (a DPP-1 inhibitor) to treat bronchiectasis, and the effect of alteplase administered 4.5 to 24 hours after stroke in patients with mild posterior circulation stroke who did not receive thrombectomy. Two papers, here we go!Phase 3 Trial of the DPP-1 Inhibitor Brensocatib in Bronchiectasis (0:00 – 12:46)Alteplase for Posterior Circulation Ischemic Stroke at 4.5 to 24 Hours (12:47 – 24:55)And for the Good Stuff (24:56 – 26:08):Medicine Pods qMonthly newsletter Questions? Comments? Feedback? We'd love to hear from you! @roundstable @InternAtWork @MedicinePods

Thrombectomy for acute ischaemic stroke has undergone great advances in the last decade, but the expertise and technology is restricted to tertiary hospitals. Outside of large metropolitan centres, thrombolytic treatment can buy a patient time, but for almost 30 years the first line agent has remained unchanged. Alteplase is an analog of the human tissue plasminogen activator which activates plasmin to dissolve fibrin blood clots. For many years it was assumed that alteplase should be administered within 3 hours of symptom onset, thus it was a big deal when in 2008, research showed that that window could be safely broadened out to four and a half hours.Today's guests have over the intervening years been pushing the envelope even further, in an effort to help the more than two thirds of stroke patients who present after that threshold. In this podcast, Professors Bruce Campbell and Mark Parsons discuss a trial of the relatively novel agent, tenecteplase. The publication in the New England Journal of Medicine showed that tenecteplase could improve patient outcomes even if administered up to 24 hours out from a large vessel occlusion. The researchers explain the steps that led up to their study, and the importance of perfusion imaging to identify candidates with salvageable brain tissue. Key ReferenceTenecteplase for Ischemic Stroke at 4.5 to 24 Hours without Thrombectomy [NEJM. 2024]GuestsDr Duncan Austin PhD FRACP MRCP (Cabrini Health) Professor Bruce Campbell PhD FRACP (Cabrini Health; Royal Melbourne Hospital; University of Melbourne) Professor Mark Parsons PhD FRACP, FAAHMS (Sydney Neurointerventional Specialists; Consulting in Neurology, Maitland). ProductionProduced by Mic Cavazzini DPhil. Music licenced from Epidemic Sound includes ‘Things to Sort Out' by Walt Adams and ‘the Appalachian Trail' by Hunter Quinn. Image produced and copyrighted by RACP.Editorial feedback kindly provided by RACP physicians Stephen Bacchi, Aidan Tan, Courtney Dowd, Saion Chaterjee and David Arroyo.  Please visit the Pomegranate Health web page for a transcript and supporting references.Login to MyCPD to record listening and reading as a prefilled learning activity. Subscribe to new episode email alerts or search for ‘Pomegranate Health' in Apple Podcasts, Spotify,Castbox or any podcasting app.

Host Samantha Gambles Farr, MSN, AG-ACNP, FNP-C, RNFA, is joined by Roman Melamed, MD, to discuss the comparative effectiveness of reduced-dose versus full-dose alteplase for acute pulmonary embolism, focusing on patient outcomes and complications. They will highlight study findings on significant improvements in hemodynamic and respiratory parameters in both groups, with a lower rate of hemorrhagic complications in the reduced-dose group (Melamed R, et al. Crit Care Med. 2024;52:729-742). Dr. Melamed is a critical care intensivist and director of the Pulmonary Embolism Program at Abbott Northwestern Hospital in Minneapolis, Minnesota, USA, and an adjunct associate professor at the University of Minnesota.

In this episode, we discuss the process of fibrinolysis in relation to coagulation cascade and the pharmacology of Alteplase.

In part two of this two-part series, Dr. Dan Ackerman and Dr. Gaspard Gerschenfeld discuss the differences in treatment between American Stroke Centers and those in France. Show reference: https://www.neurology.org/doi/10.1212/WNL.0000000000209398  

Dr. Dan Ackerman and Dr. Gaspard Gerschenfeld discuss the efficacy and safety of both thrombolytics in patients with large ischemic core.  Show reference: https://www.neurology.org/doi/10.1212/WNL.0000000000209398  

Dr. Dan Ackerman talks with Dr. Gaspard Gerschenfeld about the efficacy and safety of both thrombolytics in patients with large ischemic core. Read the related article in Neurology.  Disclosures can be found at Neurology.org.

Welcome back Rounds Table Listeners!In this throwback episode, Drs. John Fralick and Justin Boyle discuss early versus late anticoagulation after stroke with atrial fibrillation and dual antiplatelet therapy versus alteplase in minor ischemic stroke.Early versus Later Anticoagulation for Stroke with Atrial Fibrillation (0:00 – 8:48).Dual Antiplatelet Therapy vs Alteplase for PatientsWith Minor Nondisabling Acute Ischemic Stroke: The ARAMIS Randomized Clinical Trial (8:48 – 16:20).And for the Good Stuff:Taylor Swift makes history with more No. 1 albums than any female artist (16:20 – 17:03).‘I finally did it': Ottawa's Michael Woods wins 9th stage of Tour de France (17:03 – 18:00).Questions? Comments? Feedback? We'd love to hear from you! @roundstable

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021. Originally released: May 20, 2018 It's the age of thrombectomy. The DAWN of a new era. But should we give up on intravenous thrombolysis for acute ischemic stroke? In this installment of the Quanta series (typically shorter episodes, this one happens to be 19 minutes), we review the latest data on fibrinolytic agents and anticipate the upcoming paradigm shift in the management of patients with cerebral infarction. Produced by James E Siegler. Music by Hyson and Jon Watts. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making. REFERENCESAssessment of the Safety and Efficacy of a New Thrombolytic (ASSENT-2) Investigators; Van De Werf F, Adgey J, et al. Single-bolus tenecteplase compared with front-loaded alteplase in acute myocardial infarction: the ASSENT-2 double-blind randomised trial. Lancet 1999;354(9180):716-22. PMID 10475182Campbell BC, Mitchell PJ, Churilov L, et al. Tenecteplase versus alteplase before thrombectomy for ischemic stroke. N Engl J Med 2018;378(17):1573-82. PMID 29694815Haley EC Jr, Lyden PD, Johnston KC, Hemmen TM; TNK in Stroke Investigators. A pilot dose-escalation safety study of tenecteplase in acute ischemic stroke. Stroke 2005;36(3):607-12. PMID 15692126Haley EC Jr, Thompson JL, Grotta JC, et al. Phase IIB/III trial of tenecteplase in acute ischemic stroke: results of a prematurely terminated randomized clinical trial. Stroke 2010;41(4):707-11. PMID 20185783Huang X, Cheripelli BK, Lloyd SM, et al. Alteplase versus tenecteplase for thrombolysis after ischaemic stroke (ATTEST): a phase 2, randomised, open-label, blinded endpoint study. Lancet Neurol 2015;14(4):368-76. PMID 25726502Logallo N, Novotny V, Assmus J, et al. Tenecteplase versus alteplase for management of acute ischaemic stroke (NOR-TEST): a phase 3, randomised, open-label, blinded endpoint trial. Lancet Neurol 2017;16(10):781-8. PMID 28780236Parsons M, Spratt N, Bivard A, et al. A randomized trial of tenecteplase versus alteplase for acute ischemic stroke. N Engl J Med 2012;366(12):1099-107. PMID 22435369 We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode's original release date.

Show notes at pharmacyjoe.com/episode891. In this episode, I’ll discuss an article comparing half-dose to full-dose alteplase for pulmonary embolism. The post 891: The Half-Dose Alteplase Study You’ve Always Wanted appeared first on Pharmacy Joe.

Show notes at pharmacyjoe.com/episode891. In this episode, I’ll discuss an article comparing half-dose to full-dose alteplase for pulmonary embolism. The post 891: The Half-Dose Alteplase Study You’ve Always Wanted appeared first on Pharmacy Joe.

Background: Massive pulmonary embolism  defined as sustained hypotension (SBP

The November 2023 replay of past episodes showcases five interviews on topics in stroke. The episode begins with an interview with Dr. Imogene Scott on prehospital telestroke vs paramedic scores to accurately identify stroke reperfusion candidates. The episode continues with an interview with Dr. David Seiffge on the use of oral anticoagulants on ischemic stroke. The next interview is with Dr. Alejandro Rabinstein and Hassan Kobeissi on comparing outcomes between CTP and NCCT for endovascular therapy selection in the late therapeutic window. The fourth interview is with Dr. Thanh Nguyen discussing whether dual antiplatelet therapy is non-inferior to intravenous thrombolysis among patients with minor non-disabling acute ischemic stroke. The November Recall concludes with Dr. Seemant Chaturvedi discussing this year's European Stroke Organization Conference and pivotal trials that were presented during the conference. Related Podcast Links: Pre-Hospital Evaluation of Acute Stroke: EMS vs Telemed: https://directory.libsyn.com/episode/index/id/24928863 Intravenous Thrombolysis in Patients With Ischemic Stroke and Recent Ingestion of Direct Oral Anticoagulants: https://directory.libsyn.com/episode/index/id/25736865  CT Perfusion vs CT for Late Window Stroke Thrombectomy: https://directory.libsyn.com/episode/index/id/26673237 Dual Antiplatelet Therapy vs Alteplase for Patients With Acute Ischemic Stroke:  https://directory.libsyn.com/episode/index/id/27455412 Pivotal Stroke Trials Presented at this Year's ESOC: https://directory.libsyn.com/episode/index/id/27279144 Related Article Links: Prehospital Telestroke vs Paramedic Scores to Accurately Identify Stroke Reperfusion Candidates: A Cluster Randomized Controlled Trial: https://n.neurology.org/content/99/19/e2125 Intravenous Thrombolysis in Patients With Ischemic Stroke and Recent Ingestion of Direct Oral Anticoagulants: https://jamanetwork.com/journals/jamaneurology/fullarticle/2799622 CT Perfusion vs Noncontrast CT for Late Window Stroke Thrombectomy: A Systematic Review and Meta-analysis: https://n.neurology.org/content/100/22/e2304 Dual Antiplatelet Therapy vs Alteplase for Patients With Minor Nondisabling Acute Ischemic Stroke: The ARAMIS Randomized Clinical Trial: https://jamanetwork.com/journals/jama/article-abstract/2806532 ESOC Plenary: https://2023.eso-conference.org/programme/plenary-highlights/ Disclosures can be found at Neurology.org

In this episode, we review the role and indications of thrombolytics in acute ischemic stroke. The efficacy, safety, administration considerations, and cost between alteplase and tenecteplase are compared and contrasted. Key Concepts Alteplase (Activase) is a recombinant DNA version of human TPA (tissue plasminogen activator). Tenecteplase (TNKase) is similar to human TPA except it has three amino acid changes that result in a longer half-life and higher fibrin specificity. In patients with stroke, alteplase is given as a bolus followed by a 60-minute infusion. Tenecteplase is given as an IV bolus without the need for an infusion due to its longer half-life. Tenecteplase is at least as safe and effective as alteplase in acute ischemic stroke (with some studies showing greater benefit with tenecteplase). In patients with acute ischemic stroke who are candidates for mechanical thrombectomy, thrombolytics (with alteplase or tenecteplase) will still be given in patients who meet inclusion criteria and have no exclusion criteria. References Powers WJ, Rabinstein AA, Ackerson T, et al. Guidelines for the Early Management of Patients With Acute Ischemic Stroke: 2019 Update to the 2018 Guidelines for the Early Management of Acute Ischemic Stroke: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association [published correction appears in Stroke. 2019 Dec;50(12):e440-e441]. Stroke. 2019;50(12):e344-e418. doi:10.1161/STR.0000000000000211 Campbell BCV, Mitchell PJ, Churilov L, et al. Tenecteplase versus Alteplase before Thrombectomy for Ischemic Stroke. N Engl J Med. 2018;378(17):1573-1582. doi:10.1056/NEJMoa1716405 Kobeissi H, Ghozy S, Turfe B, et al. Tenecteplase vs. alteplase for treatment of acute ischemic stroke: A systematic review and meta-analysis of randomized trials. Front Neurol. 2023;14:1102463. Published 2023 Jan 23. doi:10.3389/fneur.2023.1102463

O TdC comemora seu quarto ano de existência com mais um episódio comemorativo! Qual o melhor remédio aos olhos do TdC? Ceftriaxone ou Metformina? Noradrenalina ou Alteplase? Enoxaparina ou Carvedilol? Veja essa discussão sem sentido aqui!

On this episode, we are joined by Dr. Brian Gilbert, PharmD, BCCCP, FCCM, FNCS, to compare and contrast alteplase (tPA) versus tenecteplase (TNK-tPA) in the setting ischemic stroke. Brian is an emergency medicine clinical pharmacy specialist at Wesley Medical Center. He also serves as the PGY-2 critical care pharmacy residency program director and as an adjunct assistant clinical professor at the University of Kansas School of Pharmacy.  Thanks for listening! We want to give a big thanks to our main sponsor Pyrls. Try out their drug information app today. Visit the website below for a free trial: www.pyrls.com/corconsultrx If you want to support the podcast, check out our Patreon account. Subscribers will have access to all previous and new pharmacotherapy lectures as well as downloadable PowerPoint slides for each lecture. You can find our account at the website below:  www.patreon.com/corconsultrx If you have any questions for Cole or me, reach out to us on any of the following: Text - 415-943-6116 Mike - mcorvino@corconsultrx.com Cole - cswanson@corconsultrx.com Instagram and other social media platforms - @corconsultrx  This podcast reviews current evidence-based medicine and pharmacy treatment options. This podcast is intended to be used for educational purposes only and is intended for healthcare professionals and students. This podcast is not for patients and not intended as advice or treatment.

Thrombolytics are the standard of care for acute stroke yet are not without risk. Join host, Geoff Wall, with guest, Jake Galdo, as they discuss combination aspirin and clopidogrel versus thrombolytics in mild stroke. The GameChangerThrombolytic use in mild stroke is common due to the time factor of administration, but data is mixed. New research has shown DAPT to be non-inferior to TPA. HostGeoff Wall, PharmD, BCPS, FCCP, BCGPProfessor of Pharmacy Practice, Drake UniversityInternal Medicine/Critical Care, UnityPoint HealthJake Galdo, PharmD, MBA, BCPS, BCGPCourse Content and Developer, CEimpactManaging Network Facilitator, CPESN Health EquityCEO, Seguridad ReferenceChen H, Cui Y, Zhou Z, et al. Dual Antiplatelet Therapy vs Alteplase for Patients With Minor Nondisabling Acute Ischemic Stroke: The ARAMIS Randomized Clinical Trial. JAMA. 2023;329(24):2135–2144. doi:10.1001/jama.2023.7827https://jamanetwork.com/journals/jama/article-abstract/2806532 Pharmacist Members, REDEEM YOUR CPE HERE! Not a member? Get a Pharmacist Membership & earn CE for GameChangers Podcast episodes! (30 mins/episode)CPE Information Learning ObjectivesUpon successful completion of this knowledge-based activity, participants should be able to:1. Discuss how the inclusion and exclusion criteria impact the interpretation of the ARIMIS study 2. Describe the potential benefits of DAPT therapy compared to thrombolytic therapy in mild stroke0.05 CEU/0.5 HrUAN: 0107-0000-23-249-H01-PInitial release date: 7/31/2023Expiration date: 7/31/2024Additional CPE details can be found here.Follow CEimpact on Social Media:LinkedInInstagramDownload the CEimpact App for Free Continuing Education + so much more!

Dr. Thanh Nguyen discusses his paper, "Dual Antiplatelet Therapy vs Alteplase for Patients With Minor Nondisabling Acute Ischemic Stroke". Show references: https://jamanetwork.com/journals/jama/article-abstract/2806532 This episode was sponsored by the ExTINGUISH Trial for NMDAR Encephalitis: Call 844-4BRAIN5 to refer patients.

Dr. Dan Ackerman talks with Dr. Thanh Nguyen about whether dual antiplatelet therapy is noninferior to intravenous thrombolysis among patients with minor nondisabling acute ischemic stroke. Read the related article in JAMA. Visit NPUb.org/Podcast for associated article links. This episode was sponsored by the ExTINGUISH Trial for NMDAR Encephalitis: Call 844-4BRAIN5 to refer patients.

Contributor: Aaron Lessen, MD Educational Pearls: What is thrombolysis? Thrombolysis is performed by administration of a medication that promotes the body's natural ability to break up clots. These medications include Alteplase (tPA) and Tenecteplase (TNK). The main side effect of using such an agent is bleeding which typically occurs at puncture sites but can also occur internally. However, an unusual side effect of thrombolytic agents, which occurs in about 1-5% of cases, is angioedema. What is angioedema? Angioedema is a medical condition that causes swelling beneath the surface of the skin, typically in the face, lips, and throat (orolingual angioedema). Fluid leaks from blood vessels and accumulates in the deeper layers of the skin. How are these two connected? The mechanism by which angioedema occurs after thrombolysis is not well understood, but it is likely connected to how tPA can increase levels of bradykinin and histamine. Swelling can appear suddenly but can also occur up to 24 hours after thrombolysis, and may last for a few hours or several days. In some cases, angioedema can affect the airways, leading to difficulty breathing. What can be done? If this side effect occurs the provider can stop the medication or infusion and treat the patient with anti-histamines, steroids, epinephrine, and airway monitoring. Medications such as Berinert or Icatibant, typically used in hereditary angioedema or ACE-i-induced angioedema, can also be used but have limited evidence for their efficacy. Fun fact tPA-related angioedema is about 4 times more likely in patients on ACE inhibitors. This is likely related to how ACE inhibitors also increase bradykinin and histamine in a patient's body. References Zhu A, Rajendram P, Tseng E, Coutts SB, Yu AYX. Alteplase or tenecteplase for thrombolysis in ischemic stroke: An illustrated review. Res Pract Thromb Haemost. 2022 Sep 20;6(6):e12795. doi: 10.1002/rth2.12795. PMID: 36186106; PMCID: PMC9487449. Pahs L, Droege C, Kneale H, Pancioli A. A Novel Approach to the Treatment of Orolingual Angioedema After Tissue Plasminogen Activator Administration. Ann Emerg Med. 2016 Sep;68(3):345-8. doi: 10.1016/j.annemergmed.2016.02.019. Epub 2016 May 10. PMID: 27174372. Burd M, McPheeters C, Scherrer LA. Orolingual Angioedema After Tissue Plasminogen Activator Administration in Patients Taking Angiotensin-Converting Enzyme Inhibitors. Adv Emerg Nurs J. 2019 Jul/Sep;41(3):204-214. doi: 10.1097/TME.0000000000000250. PMID: 31356244. Sczepanski M, Bozyk P. Institutional Incidence of Severe tPA-Induced Angioedema in Ischemic Cerebral Vascular Accidents. Crit Care Res Pract. 2018 Sep 27;2018:9360918. doi: 10.1155/2018/9360918. PMID: 30363665; PMCID: PMC6180929. Summarized by Jeffrey Olson, MS1 | Edited by Meg Joyce & Jorge Chalit, OMS1

Tenecteplase in Acute Ischemic Stroke  Special Guest: Salia Farrokh, PharmD, BCCCP, FNCS 07:45 – Alteplase history and comparison 14:20 – Thrombolysis guidelines in AIS 19:15 – Tips for reading stroke literature 21:00 – Tenecteplase literature review  39:45 – Tenecteplase research-in-progress 42:30 – Thrombolytic-induced ICH management 46:25 – Arguments for and against Tenecteplase 51:30 – Advice when switching thrombolytics 58:20 – Ultimate take-aways Reference List: https://pharmacytodose.files.wordpress.com/2023/04/tenecteplase-in-acute-ischemic-stroke-references.pdf PharmacyToDose.Com  @PharmacyToDose  PharmacyToDose@Gmail.com Learn more about your ad choices. Visit megaphone.fm/adchoices

Editor's Summary by Kirsten Bibbins-Domingo, PhD, MD, MAS, Editor in Chief of JAMA, the Journal of the American Medical Association, for the February 28, 2023, issue. Related Content: Audio Highlights

Bradyarrhythmia during AF screening, thrombolysis in stroke, NP vs MD care, and the most biased paper this year — on LAAO — are the topics John Mandrola, MD, discusses in this week's podcast. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I. Screening with ILR - Ade Adamson Tweet https://twitter.com/AdeAdamson/status/1625878856820482048?s=20 - The Rapid Rise in Cutaneous Melanoma Diagnoses https://www.nejm.org/doi/full/10.1056/NEJMsb2019760 - Loop Trial https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)01698-6/fulltext - Prevalence and Prognostic Significance of Bradyarrhythmias in Patients Screened for Atrial Fibrillation vs Usual Care https://jamanetwork.com/journals/jamacardiology/fullarticle/2801362 II. Thrombolysis in Mild Stroke Thrombolysis Not Necessary in Mild Nondisabling Stroke: ARAMIS https://www.medscape.com/viewarticle/988381 - PRISMS Trial https://jamanetwork.com/journals/jama/fullarticle/2687354 - Risk of selection bias assessment in the NINDS rt-PA stroke study https://pubmed.ncbi.nlm.nih.gov/35705913/ - Tissue Plasminogen Activator for Acute Ischemic Stroke https://www.nejm.org/doi/full/10.1056/NEJM199512143332401 - Effects of alteplase for acute stroke; Hacke et al meta-analysis https://journals.sagepub.com/doi/10.1177/1747493017744464 - Methodological survey of missing outcome data in an alteplase for ischemic stroke meta-analysis https://onlinelibrary.wiley.com/doi/full/10.1111/ane.13656 - ECASS; Thrombolysis with Alteplase 3 to 4.5 Hours after Acute Ischemic Stroke https://www.nejm.org/doi/full/10.1056/nejmoa0804656 - Thrombolysis with alteplase 3-4.5 hours after acute ischaemic stroke: trial reanalysis adjusted for baseline imbalances https://pubmed.ncbi.nlm.nih.gov/32430395/ III. NP vs MD Care This Doc Still Supports NP/PA Led Care ... With Caveats https://www.medscape.com/viewarticle/967073 - The Productivity of Professions: Evidence from the Emergency Department https://www.nber.org/papers/w30608 - Independent Nurse Practitioners and Physician Assistants: A Doc's View https://www.medscape.com/viewarticle/924047 IV. LAAO vs OAC - Comparative Effectiveness of Left Atrial Appendage Occlusio Versus Oral Anticoagulation by Sex https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.122.062765 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact news@medscape.net

Prof. Urs Fischer discusses his paper, "Thrombectomy alone versus intravenous alteplase plus thrombectomy in patients with stroke: an open-label, blinded-outcome, randomised non-inferiority trial". Show references: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(22)00537-2/fulltexthttps://www.sciencedirect.com/science/article/abs/pii/S0140673622005372?dgcid=coauthor#! This podcast is sponsored by argenx. Visit www.vyvgarthcp.com for more information.

Dr. Dan Ackerman talks with Prof. Urs Fischer about the use of thrombectomy alone versus intravenous alteplase plus thrombectomy in patients with acute ischemic stroke.   This podcast is sponsored by argenx. Visit www.vyvgarthcp.com for more information.

Dr. James Braun, Neurosciences Pharmacy Clinical Specialist at SSM Health St. Louis, and Dr. Kyle Hoelting, Senior Manager of Drug Information at Vizient, continue to share their insights on the use of TNK vs Alteplase for treating acute ischemic stroke. They also discuss the nuances of this therapeutic area and share recent work from an expert panel led by Vizient.   Guest speakers: James Braun, PharmD, BCCCP Neurosciences Pharmacy Clinical Specialist  SSM Health   Kyle Hoelting, PharmD, BCPS Senior Manager of Drug Information  Vizient   Moderator: Gretchen Brummel, PharmD, BCPS Pharmacy Executive Director Vizient Center for Pharmacy Practice Excellence   Show Notes: [00:30-3:59] Medication safety risks associated with thrombolytics [04:00-4:42] Using one drug over another [04:43-6:48] How frontline pharmacy staff can utilize this information [06:49-11:44] What Vizient can add to the discussion [11:45-11:55] When report will be released   Links | Resources: Tenecteplase vs alteplase in acute ischemic stroke: Vizient expert panel Verified Rx: Evidenced based medicine Click here Verified Rx: Show me the data! Updates on the evidence of thrombolytic use in ischemic strokes Click here Verified Rx: Information overload: tips and tricks for staying on top of the literature, part 1 Click here Verified Rx: Information overload: tips and tricks for staying on top of the literature, part 2 Click here   Subscribe Today! Apple Podcasts Amazon Podcasts Google Podcasts Spotify Stitcher Android RSS Feed

Dr. James Braun, Neurosciences Pharmacy Clinical Specialist at SSM Health St. Louis, and Dr. Kyle Hoelting, Senior Manager of Drug Information at Vizient, share their insights on the use of tenecteplase vs alteplase for treating acute ischemic stroke. They also discuss the nuances of this therapeutic area and share recent work from an expert panel led by Vizient.   Guest speakers: James Braun, PharmD, BCCCP Neurosciences Pharmacy Clinical Specialist  SSM Health   Kyle Hoelting, PharmD, BCPS Senior Manager of Drug Information  Vizient   Moderator: Gretchen Brummel, PharmD, BCPS Pharmacy Executive Director Vizient Center for Pharmacy Practice Excellence   Show Notes: [00:58-3:00] James' background and his role in the treatment of stroke patients [03:01-5:09] History of tenecteplase and alteplase for ischemic stroke [05:10-6:56] Information about trials of alteplase [06:57-8:11] Where Tenecteplase fits in discussion [08:12-9:51] Differences with tenecteplase and alteplase to clinicians [9:52-12:00] What studies say about potential, practical advantages of tenecteplase [12:01-19:55] Making the switch between agents   Links | Resources: Verified Rx: Evidenced based medicine Click here Verified Rx: Show me the data! Updates on the evidence of thrombolytic use in ischemic strokes Click here Verified Rx: Information overload: tips and tricks for staying on top of the literature, part 1 Click here Verified Rx: Information overload: tips and tricks for staying on top of the literature, part 2 Click here Identifying errors and safety considerations in patients undergoing thrombolysis in acute ischemic stroke Click here EXTEND-IA TNK Click here Australian-TNK Click here Meta-analysis NIHSS outcomes Click here NOR-TEST Click here   Subscribe Today! Apple Podcasts Amazon Podcasts Google Podcasts Spotify Stitcher Android RSS Feed

Huge thanks to Podcorn for sponsoring this episode. Explore sponsorship opportunities and start monetizing your podcast by signing up here: https://podcorn.com/podcasters/ The post Episode 75. Alteplase vs Tenecteplase for Ischemic Stroke by Jim Priano appeared first on The Pharm So Hard Podcast.

Should we be considering tPA (alteplase) as a last-ditch effort to try to improve oxygenation in our COVID-19 patients? Show Notes: https://eddyjoemd.com/tpa-covid/ Although great care has been taken to ensure that the information in this podcast are accurate, eddyjoe, LLC shall not be held responsible or in any way liable for the continued accuracy of the information, or for any errors, omissions or inaccuracies, or for any consequences arising therefrom. Citation: Barrett CD, Moore HB, Moore EE, Wang J, Hajizadeh N, Biffl WL, Lottenberg L, Patel PR, Truitt MS, McIntyre RC Jr, Bull TM, Ammons LA, Ghasabyan A, Chandler J, Douglas IS, Schmidt EP, Moore PK, Wright FL, Ramdeo R, Borrego R, Rueda M, Dhupa A, McCaul DS, Dandan T, Sarkar PK, Khan B, Sreevidya C, McDaniel C, Grossman Verner HM, Pearcy C, Anez-Bustillos L, Baedorf-Kassis EN, Jhunjhunwala R, Shaefi S, Capers K, Banner-Goodspeed V, Talmor DS, Sauaia A, Yaffe MB. Study of Alteplase for Respiratory Failure in SARS-CoV-2 COVID-19: A Vanguard Multicenter, Rapidly Adaptive, Pragmatic, Randomized Controlled Trial. Chest. 2022 Mar;161(3):710-727. doi: 10.1016/j.chest.2021.09.024. Epub 2021 Sep 27. PMID: 34592318; PMCID: PMC8474873. --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app Support this podcast: https://anchor.fm/eddyjoemd/support

Editor's Summary by Anne Cappola, MD, Associate Editor of JAMA, the Journal of the American Medical Association, for the March 1, 2022 issue.

JAMA Medical News Senior Staff Writer Melissa Suran speaks with Louise McCullough, MD, PhD, about new research and timely topics from the American Heart Association and American Stroke Association's annual International Stroke Conference. McCullough, who chaired this year's conference, is also chair of neurology at the University of Texas Health Science Center at Houston and chief of neurology at Memorial Hermann—Texas Medical Center. Related Content: Highlights From the International Stroke Conference 2022—Thrombectomy and Alteplase, Access to Stroke Centers, and Warfarin vs Direct Oral Anticoagulants

In this debate style presentation from the 2020 Midyear Clinical Meeting, our content matter experts will review the key literature on both Alteplase and Tenecteplase and their roles in the management of acute ischemic stroke and how their pharmacokinetic and structural differences play a role in therapy.  The information presented during the podcast reflects solely the opinions of the presenter. The information and materials are not, and are not intended as, a comprehensive source of drug information on this topic. The contents of the podcast have not been reviewed by ASHP, and should neither be interpreted as the official policies of ASHP, nor an endorsement of any product(s), nor should they be considered as a substitute for the professional judgment of the pharmacist or physician.

#542 - Como eu uso Alteplase by Cardiopapers

Quick Summary SKIP & DEVT Trials Overview on two recently published papers evaluating outcomes in patients with acute ischemic stroke undergoing mechanical thrombectomy with or without administration of alteplase.

Dr. Alemseged discusses her paper, "Tenecteplase vs Alteplase in Basilar Occlusion". Show references: https://n.neurology.org/content/early/2021/01/06/WNL.0000000000011520

In the first segment, Dr. Jason Crowell talks to Dr. Erik Musiek about disease-modifying therapy in Alzheimer disease. In the second part of the podcast, Dr. Andrew Southerland talks with Dr. Fana Alemseged about tenecteplase versus alteplase in basilar artery occlusion.

Have you been trying to keep up with the medical literature, but you don't have the time, don't know where to start, and would like someone to do the legwork for you?Your ears are in the right place.We cover:Alteplase and improved stroke outcomesTranexamic acid and SAHAblation trial AFAAA and fluoroquinolonesOccult blood and risk of ischaemic strokeFaecal transplant for melanomaGut microbiome and link to depressionLow socioeconomic status and cardiac arrestType 2 MI medicationsSurgery and type 2 diabetesOxygen saturation and ethnicityTopical steroidsAcute appendicitis and antibioticsGet in touch:Twitter,  Facebook, Instagram, or journalspotting@gmail.com

Background: Intravenous alteplase is the current standard care for treatment of acute ischemic stroke (AIS) despite active debate on the research supporting its use.  The... The post REBEL Cast Ep92: Alteplase for Stroke of Unknown Time of Onset? appeared first on REBEL EM - Emergency Medicine Blog.

In Part 2 of 2 of our "Mini Grand Rounds" series, we discuss the use of thrombolytics in the setting of cardiac arrest and wrap it up with our final recommendations.References:Lederer W, Lichtenberger C, Pechlaner C, et al. Recombinant tissue plasminogen activator during cardiopulmonary resuscitation in 108 patients with out‐of‐hospital cardiac arrest. Resuscitation 2001; 50(1): 71-76Abu-Laban RB, Christenson JM, Innes GD, et al. Tissue plasminogen activator in cardiac arrest with pulseless electrical activity. N Engl J Med 2002; 346: 1522-8Comess KA, DeRook FA, Russell ML, et al. The incidence of pulmonary embolism in unexplained sudden cardiac arrest with pulseless electrical activity. Am J Med 2000; 109: 351-6Courtney DM, Kline JA. Prospective use of a clinical decision rule to identify pulmonary embolism as likely cause of outpatient cardiac arrest. Resuscitation 2005; 65: 57-64Neumar RW, Otto CWL MS, Kronik SI, et al. Part 8: Adult advanced cardiovascular   life support: 2010 American Heart Association guidelines for cardiopulmonary   resuscitation and emergency cardiovascular care. Circulation 2010; 122: S729-67

In Part 1 of 2 of our "Mini Grand Rounds" series, we discuss the use of thrombolytics in the setting of submassive and massive pulmonary embolism. Tune in as we review studies and guidelines that discuss these agents in these settings, as well as appropriate dosing and administration of alteplase. References: Konstantinides S, Geibel A, Heusel G, et al. Heparin plus alteplase compared with heparin alone in patients with submassive pulmonary embolism. NEJM. 2002; 347(15): 1143-1150Sharifi M, Bay C, Skrocki L, et al. Moderate Pulmonary Embolism Treated With Thrombolysis (from the "MOPETT" Trial). Am J Cardiol. 2013; 111(2): 273-277Meyer G, Vicaut E, Danays T, et al. Fibrinolysis for patients with intermediate-risk pulmonary embolism. NEJM. 2014; 370: 1402-1411Wang, et al. Efficacy and safety of low dose recombinant tissue-type plasminogen activator for the treatment of acute pulmonary thromboembolism. Chest. 2010; 137(2): 254-262Zhang, et al. Lower dosage of recombinant tissue-type plasminogen activator (rt-PA) in the treatment of acute pulmonary embolism: a systematic review and meta-analysis. Thrombosis Research. 2013;133: 357-363

Join us for a quick review on a recently-published study describing the association between alteplase door-to-needle times and long-term patient outcomes in the setting of ischemic stroke. Please subscribe to our Podcast ("ER-Rx") and leave us a review! References: Man S, Xian Y, Holmes DN, et al. Association between thrombolytic door-to-needle time and 1-year mortality and readmission in patients with acute ischemic stroke. JAMA; 2020: 323(21): 2170-2184Gilbert BW, Huffman J. Effect on door-to-needle recombinant tissue plasminogen activator administration times for acute ischemic stroke with and without an emergency department pharmacist. J Am Coll Clin Pharm; 2019: 2: 628-632Phan K, Degener M. Pharmacists improve door to needle times in the emergency department. Poster presented at: International Stroke Conference 2020. February 12, 2020

Show notes at pharmacyjoe.com/episode496. In this episode, I’ll discuss whether alteplase can be used to treat COVID-19 patients with thrombotic disseminated intravascular coagulation. The post 496: Can alteplase be used to treat COVID-19 patients with thrombotic disseminated intravascular coagulation? appeared first on Pharmacy Joe.

Commentary by Dr. Valentin Fuster

Are there any drugs being investigated for the treatment of COVID-19? Find out about this and more in today's PV Roundup podcast.

Show notes at pharmacyjoe.com/episode465. In this episode, I ll discuss the use of alteplase for suspected Impella device thrombosis The post 465: Use of Alteplase for Suspected Impella Device Thrombosis appeared first on Pharmacy Joe.

Background: Currently, alteplase is the mainstay of treatment of acute ischemic stroke.  Advocates of alteplase suggest that the benefit of alteplase is greatest when given early... The post REBEL Cast Ep72: Systemic Alteplase in Stroke Mimics is Safe? appeared first on REBEL EM - Emergency Medicine Blog.

Show notes at pharmacyjoe.com/episode432. In this episode, I ll discuss how long patients need to be monitored in the ICU after receiving alteplase for acute ischemic stroke. The post 432: How long do patients need to be monitored in the ICU after receiving alteplase for acute ischemic stroke? appeared first on Pharmacy Joe.

Show notes at pharmacyjoe.com/episode419. In this episode, I ll discuss when the acute ischemic stroke guidelines recommend stopping alteplase mid-infusion. The post 419: When do acute ischemic stroke guidelines recommend stopping alteplase mid-infusion? appeared first on Pharmacy Joe.

In this episode, I ll discuss giving alteplase for acute ischemic stroke during pregnancy. Show notes at pharmacyjoe.com/episode404. The post 404: Can alteplase be given for acute ischemic stroke during pregnancy? appeared first on Pharmacy Joe.

The EXTEND-IA TNK trial showed that for acute ischemic stroke, intravenous tenecteplase was as effective as alteplase for achieving good functional outcomes in acute ischemic stroke due to large vessel occlusion--and it may even be superior to alteplase. Dr. Mike Brogan interviews Dr. Bruce Campbell about the results of this pivotal trial. The NCS Podcast is the official podcast of the Neurocritical Care Society. Our senior producer is Jim Siegler. Our production staff includes Fawaz Almufti, Becca Stickney, Michael Brogan, Starane Shepherd, Benjamin Miller, and Ramani Balu. Music by Lee Roosevere. Campbell BCV, Mitchell PJ, Churilov L, et al. Tenecteplase versus Alteplase before Thrombectomy for Ischemic Stroke. The New England journal of medicine. 2018;378:1573-1582.

Author: Aaron Lessen, MD Educational Pearls: Patients with "minor" strokes with NIHSS 0 to 5  can still end up having poor long-term outcomes Recent study compared use of alteplase vs. aspirin for these patients and saw no difference in regards to favorable neurologic outcome at 90 days Study was ended early due to patient recruitment difficulties Editor's note: though ended early, it is debatable whether even if appropriately powered there would have been an identifiable benefit   References: Khatri P, Kleindorfer DO, Devlin T, Sawyer RN Jr, Starr M, Mejilla J, Broderick J, Chatterjee A, Jauch EC, Levine SR, Romano JG, Saver JL, Vagal A, Purdon B, Devenport J, Pavlov A, Yeatts SD; PRISMS Investigators. Effect of Alteplase vs Aspirin on Functional Outcome for Patients With Acute Ischemic Stroke and Minor Nondisabling Neurologic Deficits: The PRISMS Randomized Clinical Trial. JAMA. 2018 Jul 10;320(2):156-166. doi: 10.1001/jama.2018.8496. PubMed PMID: 29998337. Summary by Travis Barlock, MS4 | Edited by Erik Verzemnieks, MD  

In this episode I ll: 1. Discuss an article comparing half-dose versus full-dose alteplase for the treatment of pulmonary embolism 2. Answer the drug information question Can enoxaparin be used as anticoagulation for PE following the administration of alteplase?” 3. Share a tip for responding to inpatient medical emergencies Show notes at pharmacyjoe.com/episode318. The post 318: Half-dose versus full-dose alteplase for PE, enoxaparin vs heparin after alteplase for PE, and a tip for responding to inpatient medical emergencies appeared first on Pharmacy Joe.

1. Diagnosing Cerebral Ischemia with Door-to-Thrombolysis Times Below 20 Minutes2. What’s Trending: Tenecteplase versus Alteplase before Thrombectomy for Ischemic StrokeDr. Jimmy Berthaud speaks with Dr. Perttu Lindsberg about his paper on the accuracy and consequences of rapid stroke diagnostics in a neurological emergency department. In the second segment of the podcast, Dr. Kevin Barrett interviews Dr. Bruce Campbell about the EXTEND-IA TNK trial of tenecteplase for patients with ischemic stroke.DISCLOSURES: Dr. Berthaud reports no disclosures. Dr. Lindsberg serves as Assistant Editor for the medical journal DUODECIM; serves as chairman of the ad hoc committee on Current Therapy Guidelines in Stroke for the Finnish Medical Society; and has recieved research support for Helsinki University Hospital District, the Sigrid Jusélius Foundation, the Jane and Aatos Erkko Foundation, and the Signe and Ane Gyllenberg Foundation. Dr. Barrett has received research support from Axovant Sciences, Inc., the Virginia Center of Alzheimer's and Related Diseases, and the Department of Defense. Dr. Campbell serves on the editorial board for Stroke Stroke; served as PI of the EXTEND-IA trial, partially funded by unrestricted grant from Medtronic; and has received research support from the National Health and Medical Research Council of Australia (GNT1111972 2016-2019) and the Heart Foundation, Australia.

Show notes at pharmacyjoe.com/episode315. The post 315: How long do you continue CPR after giving IV push alteplase for pulmonary embolism related cardiac arrest? appeared first on Pharmacy Joe.

Editor's Summary by Howard Bauchner, MD, Editor in Chief of JAMA, the Journal of the American Medical Association, for the July 10, 2018 issue

Quick Summary attached (click PDF link for access)   Literature for Download    Bougie for First-Attempt Intubation success, Sux vs Roc for RSI, NBMA and effects on tracheal intubation success/outcomes, Risk of CVA and TIA with resolved afib, TNkase vs Alteplase before thrombectomy for stroke, MRI-Guided Thrombolysis for stroke with unknown onset, TXA for ICH, Vertebroplasty vs Sham procedure for compression fractures, Prehospital Spinal Immobilization for Penetrating trauma, Analysis of ED to ED transfers for traumatic injury, Allergic-like contrast reactions in the ED, Strep pharyngitis clinical mimics, IO vs IV Access in cardiac arrest and effect on mortality, Managing peripheral facial palsy, Approach to the Agitated ED patient, UDS and ED Psychiatric patients, Protocolized Lab screening for medical clearance of psych patients

Author:   Rachel Beham, PharmD Educational Pearls: Tenecteplase is more specific for fibrin and has a longer half-life than alteplase. In setting of ischemic stroke, tenecteplase before thrombectomy was associated with a statistically higher incidence of reperfusion and better functional outcome than alteplase. References Bruce C.V. Campbell B et al (2018). Tenecteplase versus Alteplase before Thrombectomy for Ischemic Stroke. New England Journal of Medicine. 378:1573-1582

Show notes at pharmacyjoe.com/episode300. In this episode, I ll discuss catheter-directed alteplase for pulmonary embolism. The post 300: Catheter-directed alteplase for pulmonary embolism appeared first on Pharmacy Joe.

It's the age of thrombectomy. The DAWN of a new era. But should we give up on intravenous thrombolysis for acute ischemic stroke? In this installment of the Quanta series (typically shorter episodes, this one happens to be 19 min...), we review the latest data on fibrinolytic agents and anticipate the upcoming paradigm shift in the management of patients with cerebral infarction. Produced by James E. Siegler. Music by Hyson and Jon Watts. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision making. REFERENCES Assessment of the S, Efficacy of a New Thrombolytic I, Van De Werf F, Adgey J, Ardissino D, Armstrong PW, Aylward P, Barbash G, Betriu A, Binbrek AS, Califf R, Diaz R, Fanebust R, Fox K, Granger C, Heikkila J, Husted S, Jansky P, Langer A, Lupi E, Maseri A, Meyer J, Mlczoch J, Mocceti D, Myburgh D, Oto A, Paolasso E, Pehrsson K, Seabra-Gomes R, Soares-Piegas L, Sugrue D, Tendera M, Topol E, Toutouzas P, Vahanian A, Verheugt F, Wallentin L and White H. Single-bolus tenecteplase compared with front-loaded alteplase in acute myocardial infarction: the ASSENT-2 double-blind randomised trial. Lancet. 1999;354:716-22. Campbell BCV, Mitchell PJ, Churilov L, Yassi N, Kleinig TJ, Dowling RJ, Yan B, Bush SJ, Dewey HM, Thijs V, Scroop R, Simpson M, Brooks M, Asadi H, Wu TY, Shah DG, Wijeratne T, Ang T, Miteff F, Levi CR, Rodrigues E, Zhao H, Salvaris P, Garcia-Esperon C, Bailey P, Rice H, de Villiers L, Brown H, Redmond K, Leggett D, Fink JN, Collecutt W, Wong AA, Muller C, Coulthard A, Mitchell K, Clouston J, Mahady K, Field D, Ma H, Phan TG, Chong W, Chandra RV, Slater LA, Krause M, Harrington TJ, Faulder KC, Steinfort BS, Bladin CF, Sharma G, Desmond PM, Parsons MW, Donnan GA, Davis SM and Investigators E-IT. Tenecteplase versus Alteplase before Thrombectomy for Ischemic Stroke. The New England journal of medicine. 2018;378:1573-1582. Huang X, Cheripelli BK, Lloyd SM, Kalladka D, Moreton FC, Siddiqui A, Ford I and Muir KW. Alteplase versus tenecteplase for thrombolysis after ischaemic stroke (ATTEST): a phase 2, randomised, open-label, blinded endpoint study. The Lancet Neurology. 2015;14:368-76. Logallo N, Novotny V, Assmus J, Kvistad CE, Alteheld L, Ronning OM, Thommessen B, Amthor KF, Ihle-Hansen H, Kurz M, Tobro H, Kaur K, Stankiewicz M, Carlsson M, Morsund A, Idicula T, Aamodt AH, Lund C, Naess H, Waje-Andreassen U and Thomassen L. Tenecteplase versus alteplase for management of acute ischaemic stroke (NOR-TEST): a phase 3, randomised, open-label, blinded endpoint trial. The Lancet Neurology. 2017;16:781-788. Parsons M, Spratt N, Bivard A, Campbell B, Chung K, Miteff F, O'Brien B, Bladin C, McElduff P, Allen C, Bateman G, Donnan G, Davis S and Levi C. A randomized trial of tenecteplase versus alteplase for acute ischemic stroke. The New England journal of medicine. 2012;366:1099-107. Haley EC, Jr., Lyden PD, Johnston KC, Hemmen TM and Investigators TNKiS. A pilot dose-escalation safety study of tenecteplase in acute ischemic stroke. Stroke; a journal of cerebral circulation. 2005;36:607-12. Haley EC, Jr., Thompson JL, Grotta JC, Lyden PD, Hemmen TG, Brown DL, Fanale C, Libman R, Kwiatkowski TG, Llinas RH, Levine SR, Johnston KC, Buchsbaum R, Levy G, Levin B and Tenecteplase in Stroke I. Phase IIB/III trial of tenecteplase in acute ischemic stroke: results of a prematurely terminated randomized clinical trial. Stroke; a journal of cerebral circulation. 2010;41:707-11.

If you talk to people about the topic of thrombolysis in PE they'll tell you about the controversy of the submassive category, but there's a universal acceptance that thrombolysing massive PE's is well evidenced and straight forward. In this episode we delve back into the literature and not only explore massive PE thrombolysis, but also the gold standard to which it is judged upon, heparin. Have a listen to the podcast and as always we would love to hear your thoughts. Enjoy! Simon & Rob References & Further Reading 2014 ESC Guidelines on the diagnosis and management of acute pulmonary embolism British Thoracic Society guidelines for the management of suspected acute pulmonary embolism; 2003 Antithrombotic Therapy for VTE Disease CHEST Guideline and Expert Panel Report; 2016 Management of Massive and Submassive Pulmonary Embolism, Iliofemoral Deep Vein Thrombosis, and Chronic Thromboembolic Pulmonary Hypertension. A Scientific Statement From the American Heart Association. 2011 Venous thromboembolic diseases: diagnosis, management and thrombophilia testing; NICE. 2012 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1438862/pdf/jrsocmed00257-0051.pdfValue of anticoagulants in the treatment of pulmonary embolism: a discussion paper. Paul Egermayer. Journal of the Royal Society of Medicine 1981. Anticoagulant drugs in the treatment of pulmonary embolism. A controlled trial. BARRITT DW. Lancet. 1960 Treatment of pulmonary embolism in total hip replacement. Johnson R. Clin Orthop Relat Res. 1977 PAIMS 2: alteplase combined with heparin versus heparin in the treatment of acute pulmonary embolism. Plasminogen activator Italian multicenter study 2. Dalla-Volta S. J Am Coll Cardiol. 1992  Alteplase versus heparin in acute pulmonary embolism: randomised trial assessing right-ventricular function and pulmonary perfusion. Goldhaber SZ. Lancet. 1993 Thrombolysis Compared With Heparin for the Initial Treatment of Pulmonary Embolism.  A Meta-Analysis of the Randomized Controlled Trials. Susan Wan. 2004 Massive PE and cardiogenic shock. To thrombolyse or not to thrombolyse, that is the question. Francoise Ticehurst. BestBets. 2004  

The post Alteplase (t-PA) Nursing Pharmacology Considerations appeared first on NURSING.com.

Later this month the medicines regulator, the MHRA, is due to complete its review into the clot-busting drug Alteplase, the frontline treatment used in many cases of stroke. A number of experts in the UK, US and Canada have raised serious doubts about the drug's safety and effectiveness. They are concerned about potentially fatal harm to patients through an increased risk of bleeding in the brain and they question the credibility of scientific research on which Alteplase was licensed. Supporters and regulators say any risks are outweighed by the benefits of improved recovery. BBC Health Correspondent Adam Brimelow assesses the evidence and the dilemma posed for doctors and their patients. Producer: Sally Chesworth.

Klaus Fassbender discusses a Review about streamlining pre-hospital management of stroke.

Research into the mental health of UK servicemen deployed in Iraq and Afghanistan.

Helen Frankish discusses articles about Huntington's disease and stroke.

Helen Frankish discusses research on childhood stroke, and add-on drug therapy for MS.

Editor Helen Frankish discusses highlights from the April issue: including the EPITHET study of alteplase treatment 3-6 hours after a stroke, and donepezil treatment in patients with CADASIL, a genetic form of vascular dementia.