Thrombolytic therapy regimens for STEMI
When a decision has been made to give thrombolytic therapy for STEMI, suitable regimens are:
1alteplase alteplase alteplase alteplase
less than 65 kg: 15 mg intravenously, followed by 0.75 mg/kg by intravenous infusion over 30 minutes, then 0.5 mg/kg over the next 60 minutes
65 kg or more: 15 mg intravenously, followed by 50 mg by intravenous infusion over 30 minutes, then 35 mg over the next 60 minutes
OR
1tenecteplase tenecteplase tenecteplase tenecteplase
less than 60 kg: 30 mg (6000 units) intravenously
60 to 69 kg: 35 mg (7000 units) intravenously
70 to 79 kg: 40 mg (8000 units) intravenously
80 to 89 kg: 45 mg (9000 units) intravenously
90 kg or more: 50 mg (10 000 units) intravenously.
For patients 75 years and older, consider using half the recommended dose of tenecteplase to reduce the risk of intracranial bleeding.
After thrombolytic therapy is given, patients should be closely monitored by staff trained in advanced life support and defibrillation. Significant arrhythmias (including ventricular fibrillation) can occur after reperfusion with thrombolytic therapy.