Question

Based on Charles' weight, what is the total dose for the rtPA infusion?

Answer 1

Recombinant Tissue Plasminogen activator (rtPA), the dose is calculated based on patient's weight.

In case of Myocardial infarction thrombolysis must be done within 30 minutes of hospital arrival.

For an accelerated infusion over 11/2 hours, if the patients weight is less than or equal to 67kg, then 15mg bolus for the initial 1 to 2 minutes and 0.75mg/kg for the next half hour(30minutes) and 0.5mg/kg for the next 1 hour(60 minutes) must be administered.

If the weight is more than 67kg 100 mg must be infused over 11/2 hour. That is to be administered as 15mg bolus in initial 1 to 2 minutes, then 50 mg in 30 minutes and the pending 35 mg in the next 1 hour.

In either cases if Charlie's weight is 245 pounds or 111kg which is above the standard weight limit given, then he must get a total rtPA of 100 mg following the timing corresponding dosages as mentioned above.

Suppose his weight is 55kg, which is below the standard weight of 67 kg, then he must get a total of 83.75 mg (84mg) of rtPA infusion.

[initial 15 mg + 0.75mg/kg for 30 minutes + 0.5mg/kg for 60 minutes = 15 + (0.75 x 55) + (0.5 x 55) = 83.75 mg]