Question

Answer Correctly and Completely.

The patient is then hooked to D5W 500cc KVO with side drip of 10mg/100cc of Nicardipine x 6 hrs. The doctor also ordered Alteplase 0.9 mg/kg IV; not to exceed 90 mg total dose; administer 10% of the total dose as an initial IV bolus over 1 minute and the remainder infused over 60 minutes. Mannitol was also ordered at 100mL q6 hours. One hour vital signs and GCS monitoring was ordered.

Question: (Provide formula)
Show the exact dosage of Altepase needed by the patient.

Answer completely and correctly.
The patient is then hooked to D5W 500cc KVO with side drip of 10mg/100cc of Nicardipine x 6 hrs. The doctor also ordered Alteplase 0.9 mg/kg IV; not to exceed 90 mg total dose; administer 10% of the total dose as an initial IV bolus over 1 minute and the remainder infused over 60 minutes. Mannitol was also ordered at 100mL q6 hours. One hour vital signs and GCS monitoring was ordered.
The patient weight is 90kgs.

Question:
Show the exact dosage of Altepase needed by the patient.

Answer 1

Alteplase (tPA) is a powerful thrombolytic agent used in the lysis of acute thromboembolism.the dosing and administration depends in the specefic conditions and depending upon the weight of patient.

Here doctor ordered maximum dose of alteplase not greater than 90mg

Ordered dose of alteplase=0.9mg/kg

Weight of patient=90kg

Maximum dose required for patient =0.9×90=81[multiplication ]

Maximum dose required for this patient is =81mg

10%of total dose as iv bolus=10%of 81mg

=8.1mg in round we can say it as 8mg as iv bolus[%calculation]

Remaining dose=toatal dose-bolus dose[substraction ]

=81-8=73

Ie, 73mg of alteplase infuse over 60mts

If altepase reconstituted with 100ml 0.9sodium chloride then we can consider 1ml/1mg

So 8ml as iv bolus as 8ml/8mg, remaining 73mg/73ml over 60mts.

Wgile administering alteplase care should be there, should not exceed the medication, it will leads to serious complications.