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dmitch
Alteplase Infusion
Does anyone have a protocol/policy for using an alteplase infusion of 2mg for repeat catheter occlusions?  And if so, any support documentation/literature? Thanks, much. 
afruitloop
In my previous

In my previous expereince, my team would place 2mg of alteplase in 25cc of solution and infuse it over 2-4 hours, in each lumen.  This created  an opportunity for the drug to dissolve more of the sheath covering the end of the catheter.  The rule we used was if a catheter was tpa'd three times, then we repalced the catheter or did the infusion.  If the catheter was replaced, we used a different arm.  The results were positive for doing this infusion.

 

Doubt if you find any literature on this but if you do, please pass it on.

Cheryl Kelley RN BSN, VA-BC

Barbara Tinsley
Using Cath Flo/ateplase as
Using Cath Flo/ateplase as an infusion is an off-lable use.  There is no evidence thru the manufacturer that an infusions does more to dissolve the firbrin shealth than the single dose administration.  I doubt that you will find any literature on this, I am not aware of any studies.

Barbara Tinsley

lynncrni
I disagree. I know that this
I disagree. I know that this has been presented at AVA conferences and I know that many nurses have used it and reported anecdotally that it works. I also know that the manufacturer may not feel the need to conduct the necessary studies in order to have the FDA allow them to include this as a labeled indication. I am almost certain that there have been some articles published about this and I will attempt to find them and put them on my blog next week. Lynn

Lynn Hadaway, M.Ed., RN, BC, CRNI

Lynn Hadaway Associates, Inc.

126 Main Street, PO Box 10

Milner, GA 30257

Website http://www.hadawayassociates.com

Office Phone 770-358-7861

Daphne Broadhurst
When developing our

When developing our Restoring CVAD Patency policy, I could only find 1 article referring to Alteplase infustions. Unfortunately, I can't locate it at home, will check if I have it at the office. This article referred to Alteplase infusions in the hemodialysis population- you may want to search these 2 terms. I'll also try to get an electronic copy our our facility's Alteplase infusion policy to post.
Daphne Broadhurst
Ottawa Canada

Daphne Broadhurst
Desjardins Pharmacy
Ottawa, Canada

Daphne Broadhurst
Diane, check out Lynn
Diane, check out Lynn Hadaway' has just posted a discussion of  Infusion of Low-Dose Tissue Plasminogen Activator , on Lynn's Blog, with several references.Daphne

Daphne Broadhurst
Desjardins Pharmacy
Ottawa, Canada

Dawn1
alteplase infusion

For those of you administering a 2 hour alteplase infusion. Does your policy specify how often it can be done for a patient?  

Thanks,

Dawn 

Dawn1
alteplase infusion

For those of you administering a 2 hour alteplase infusion. Does your policy specify how often it can be done for a patient?  

Thanks,

Dawn 

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