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| ==Thrombolytics in [[STEMI]]== | | ==Indications== |
| {{Thrombolytics STEMI}}
| | *[[Thrombolytics for acute ischemic stroke]] |
| | *[[Thrombolytics for pulmonary embolism]] |
| | *[[Thrombolytics for STEMI]] |
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| ===Indications and Contraindications<ref>Rivera-Bou WL et al. Thrombolytic therapy for acute myocardial infarction. Dec 08, 2015. http://emedicine.medscape.com/article/811234-overview#a3.</ref>=== | | ==Medications== |
| *Indications<ref>ACLS Training Center. Fibrinolytic Checklist for STEMI. https://www.acls.net/images/algo-fibrinolytic.pdf</ref>
| | *[[Alteplase]] (TPA) |
| **[[Chest pain]] > 30 min but less than 12 hrs, not relieved by NTG
| | *[[Tenecteplase]] (TNKase) |
| **PCI greater than 90 min away
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| **[[ECG]] criteria of STEMI
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| ***STE in 2 contiguous leads
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| ***Posterior STEMI
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| ***LBBB with Sgarbossa criteria
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| *Absolute contraindications
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| **Prior ICH
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| **Known cerebral vascular lesion, AVM
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| **Known intracranial malignancy, primary or mets
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| **Ischemic stroke within 3 months, but not ischemic stroke within 3 hrs
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| **Suspected aortic dissection
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| **Active bleeding or bleeding diathesis, excluding menses
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| **Significant closed head/facial trauma within 3 months
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| *Relative contraindications
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| **History of chronic, severe hypertension
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| **SBP > 180 or DBP > 110 mmHg
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| **History of prior ischemic stroke > 3 months, dementia, or other known intracranial pathology not in absolute contraindications
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| **Traumatic CPR or CPR > 10 min
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| **Major surgery within 3 wks
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| **Internal bleeding within 2-4 wks
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| **Noncompressible vascular punctures
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| **Prior allergic reactions to fibrinolytics
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| **Pregnancy
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| **Active PUD
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| **Use of anticoagulants
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| ==[[Thrombolysis in Acute Ischemic Stroke (tPA)]]== | | ==See Also== |
| {{TPA Stroke}}
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| ==Thrombolysis in Pulmonary Embolism==
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| *See [[pulmonary embolism]] management section
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| ==See Also==
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| *[[Ischemic stroke]]
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| *[[STEMI]]
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| ==References== | | ==References== |
| <references/> | | <references/> |
| [[Category:Cardiology]][[Category:Neurology]] | | |
| | [[Category:Cardiology]] |
| | [[Category:Neurology]] |
