To reduce mortality associated with acute myocardial infarction (AMI).
Start treatment soon after onset of AMI symptoms. Give as single IV bolus over 5 seconds. <60kg: 30mg; ≥60kg–<70kg: 35mg; ≥70kg–<80kg: 40mg; ≥80kg–<90kg: 45mg; ≥90kg: 50kg. Max: 50mg.
Tissue plasminogen activator (tPA).
Active internal bleeding. History of cerebrovascular accident. Intracranial or intraspinal surgery or trauma within 2 months. Intracranial neoplasm, arteriovenous malformation, or aneurysm. Bleeding diathesis. Severe uncontrolled hypertension.
Avoid noncompressible arterial puncture, internal jugular and subclavian venous puncture, IM injections and nonessential handling of patient during treatment. Increased bleeding risk at puncture sites; minimize arterial and venous punctures. Increased risk of complications with recent major surgery, cerebrovascular disease, GI or GU bleeding, recent trauma, hypertension (systolic BP ≥180mm Hg and/or diastolic BP ≥110mm Hg), left heart thrombus, acute pericarditis, endocarditis, hemostatic defects, hepatic dysfunction, pregnancy, hemorrhagic ophthalmic conditions, septic thrombophlebitis, elderly. Pregnancy (Cat.C). Nursing mothers.
Increased bleeding risk with heparin, vitamin K antagonists, aspirin, dipyridamole, GP IIb/IIIa inhibitors. May interfere with coagulation tests.
Bleeding, hypersensitivity reactions, cardiogenic shock, arrhythmias, AV block, pulmonary edema, heart failure, cardiac arrest, recurrent MI, myocardial rupture, cardiac tamponade, pericarditis, pericardial effusion, mitral regurgitation, thromboembolism, electromechanical dissociation, nausea, vomiting, hypotension, fever; cholesterol embolism.
Vial—1 (w. diluent, supplies)