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PICU DRUG INFORMATION
Alteplase
Thrombolytic
Occluded catheters
Intracatheter:
<30 kg: 110% of lumen volume. Use 1 mg/mL solution. (maximum: 2 mL)
Instil appropriate volume into occluded lumen. Leave in place for 30-120 minutes, then aspirate solution. Do not infuse. May repeat once if ineffective.
≥30 kg: 2 mg in 2 mL
Instil appropriate volume into occluded lumen. Leave in place for 30-120 minutes, then aspirate solution. Do not infuse. May repeat once if ineffective.
Empyema/Parapneumonic effusions
Intrapleural:
0.1 mg/kg (maximum: 4 or 6 mg)
Dilute in 20-100 mL of saline and clamp thoracostomy tube for 1 hour after administration.
Systemic thrombloytic therapy
IV:
Low dose: 0.03-0.1 mg/kg/h, typically for6-72 h (maximum: 2 mg/h)
High dose: 0.1-0.6 mg/kg/h (maximum: 1 mg/kg/h has been used but use must be weighed with associated risk of bleeding at higher rates; cumulative dose limit of 100 mg over 6 hours.) typically for 6 hours
Catheter-directed thrombolytic therapy
IV:
0.03-0.06 mg/kg/h (maximum: 2 mg/h) typically administered up to 96 hours
Pharmacology: Treatment of systemic thrombosis in which rapid dissolution of the clot is necessary to protect life, limb or organ (requires thrombosis team involvement). Empyema/parapneumonic effusion. Plasminogen activator, converts plasminogen to plasmin. Promotes fibrinolysis.
Updated: 12/21/2022
Disclaimer: This document has been created specifically for Hamilton Health Sciences (HHS) to use for its own patients and the information contained herein may not be applicable or relevant to other health care organizations. This document is for informational purposes only and is not intended to be a substitute for medical or clinical advice from a qualified health care professional. HHS makes no representations or warranties as to the accuracy of the information. This material is current only to the date listed. This material is the intellectual property of HHS and may not be shared, duplicated, or distributed further without the consent of HHS. HHS assumes no liability for the use of this information by the recipient.
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