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Alteplase is a thrombolytic agent that is manufactured by recombinant DNA technology. It is FDA approved for use in acute ischemic stroke, pulmonary embolism, acute myocardial infarction, and occluded catheters. Off-label indications include catheter-directed thrombolysis in the treatment of peripheral arterial occlusive disease and deep vein thrombosis. This activity outlines the indications, contraindications, activity, adverse events, and toxicity of alteplase in the clinical setting as relates to the essential points necessary for members of an interprofessional team managing the care of patients in need of thrombolytic therapy. Objectives: Identify the mechanism of action and proper administration of alteplase. Summarize the approved indications for alteplase. Explain the adverse event profile and potential for toxicity with alteplase. Review the importance of coordinating and collaborating among various disciplines in an interprofessional healthcare team to coordinate care and management to enhance outcomes for patients receiving thrombolytic therapy with alteplase. Access free multiple choice questions on this topic.

Alteplase is a commonly used thrombolytic agent in hospital settings. However, healthcare professionals, including all clinicians who prescribe this agent as well as pharmacists and nurses that monitor dosing, must be aware of its potential complications. Nurses will often be tasked with administering the drug, so they should familiarize themselves with dosing to be aware of possible errors and can coordinate with the pharmacist on dosing and administration. The pharmacist should also perform medication reconciliation to preclude any drug-drug interactions. If the pharmacist or nurse encounters any concerns, they should contact the clinician on duty immediately. Besides bleeding, the drug may also cause allergic reactions. It is important to know the contraindications of this agent to avoid morbidity and mortality.[8] Given the potential for bleeding, an interprofessional team approach to using alteplase is crucial for therapeutic effectiveness as well as patient safety. [Level V]