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TissuePlasminogenActivator

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WDYS: Talking about tPA | Ed in the ED

The use of Alteplase (tPA) in the setting of ischemic stroke has grown to be one of the most controversial issues in emergency medicine and for good reason. It is a trifecta of hardship: time is limited, the evidence for treatment is unclear, and patients are especially vulnerable to the information we provide when making a life changing decision. Unfortunately, most patients have not kept tabs on the literature, and when their health is on the line it is up to you to lay out their options for care.  
edintheed.com
over 5 years ago
Www.bmj
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Authors’ reply to Wardlaw and Berge

Wardlaw and Berge note the use of data from all thrombolytic trials and alteplase trials, and that distinguishing between these conclusions could be a source of confusion.1 Either way, we question the validity of “up to six hours” or “up to 4.5 hours” conclusions because:  
feeds.bmj.com
over 5 years ago
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'Clot-busting' drug could be used more widely for stroke patients, study suggests

There are concerns that for some patients, the clot-busting drug alteplase may increase the risk of a brain bleed. However, a new study claims it is safer than previously believed.  
medicalnewstoday.com
over 5 years ago
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Women and men have different exclusion criteria for rtPA

After analyzing stroke treatment records, researchers at Rhode Island Hospital in collaboration with researchers from the University of Cincinnati learned that women and men have different reasons for being excluded from receiving the common clot-dissolving drug, recombinant tissue plasminogen activator. Importantly, more women had very high blood pressures, which reduced their eligibility to be treated with the highly effective drug. The study was recently published in the American Heart Association's journal, Stroke.  
eurekalert.org
over 5 years ago
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Ensure release of all data on alteplase, doctors urge health secretary

A group of senior doctors have called on the health secretary, Jeremy Hunt, to intervene in a drive to get unpublished trial data on alteplase, a drug for acute ischaemic stroke, released in the public domain “to ensure patient safety is protected.” Until the data are released and analysed the use of alteplase should be suspended, they said.  
feeds.bmj.com
about 5 years ago
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Ensure release of all data on alteplase, doctors urge health secretary

A group of senior doctors have called on the health secretary, Jeremy Hunt, to intervene in a drive to get unpublished trial data on alteplase, a drug for acute ischaemic stroke, released in the public domain “to ensure patient safety is protected.” Until the data are released and analysed the use of alteplase should be suspended, they said.  
feeds.bmj.com
about 5 years ago
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Alteplase is safe to use within existing treatment guidelines, says independent review

The thrombolytic drug alteplase is safe and effective for licensed use up to 4.5 hours after the onset of symptoms of acute ischaemic stroke in patients for whom it is licensed, an independent expert group set up by the UK Medicines and Healthcare Products Regulatory Agency has concluded.1  
feeds.bmj.com
about 5 years ago
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Alteplase is safe to use within existing treatment guidelines, says independent review

The thrombolytic drug alteplase is safe and effective for licensed use up to 4.5 hours after the onset of symptoms of acute ischaemic stroke in patients for whom it is licensed, an independent expert group set up by the UK Medicines and Healthcare Products Regulatory Agency has concluded.1  
feeds.bmj.com
about 5 years ago
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Drugs to dissolve pulmonary embolism (blood clot in the lungs) | Cochrane

A pulmonary embolism is a potentially fatal blood clot that lodges in the main artery of the lungs, straining the right side of the heart and affecting blood circulation. Patients are also at risk of new embolisms forming (recurrence). In the case of a massive pulmonary embolism, treatment to restore blood flow is urgently required. Heparin thins the blood, but newer drugs that actively break up the clots (thrombolytics) may act more quickly and be more effective. These newer drugs include streptokinase, urokinase and recombinant tissue-type plasminogen activator. The major complication of this treatment is bleeding.  
cochrane.org
almost 5 years ago
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Cost of Thrombolysis Outpaces Reimbursement in Stroke

The cost of tissue plasminogen activator jumped 111% in the last decade, but reimbursement rose by only 8%, a new study shows, prompting calls for stroke doctors to lobby CMS to increase payments.  
medscape.com
over 4 years ago