Indication
Prehospital or in-hospital STEMI fibrinolysis.
Preparation
Reconstitute with supplied 10 mL sterile water.
Dilution
5 mg/mL
Rate
Single weight-based IV bolus over 10 sec: <60 kg 30 mg; 60–70 kg 35 mg; 70–80 kg 40 mg; 80–90 kg 45 mg; ≥90 kg 50 mg. Halve dose if ≥75 y (STREAM).
Monitoring
- • Neuro obs, BP
- • ECG q15 min post-lysis
- • Bleeding sites
Common errors
- • Overdose in elderly (must halve dose ≥75 y)
- • Concomitant full-dose antithrombotic
Pearls
- • Fibrin-specific — less systemic lysis than SK
- • Give with dual antiplatelet + enoxaparin (halved dose ≥75 y)
