Đánh giá chức năng ống thông sau 30 phút, nếu ống thông là chức năng, hút 5 ml máu ra khỏi ống thông để loại bỏ các loại thuốc và cục máu đông còn lại và sau đó tuôn ra ống thông với NS. Nếu ống thông vẫn occluded, để ở trong lòng và đánh giá lại sau 120 phút. Nếu ống thông là chức năng | 11. Anticoagulants Antithrombotics and Antiplatelets 249 occluded catheter and let it dwell in the lumen. Evaluate catheter function after 30 minutes if the catheter is functional aspirate 5mL of blood out of the catheter to remove the drug and residual clot and then flush the catheter with NS. If the catheter is still occluded leave to dwell in lumen and evaluate again after 120 minutes. If the catheter is functional aspirate 5 mL of blood and flush with NS. If the catheter remains occluded after 120 minutes a second dose may be administered by repeating the procedure Patients weighing at least 10kg and less than 30kg 1mg mL concentration do not exceed 2 mg in 2 mL Patients weighing at least 30kg 2 mg in 2 mL Systemic thrombosis initial mg kg hour intravenous . for 6 hours while monitoring for bleeding and measuring fibrinogen levels. If sufficient response is not reached within 6 hours increase dose by mg kg hour at 6-hour intervals to a maximum of mg kg hour. Maintain fibrinogen levels greater than 100 mg dL. Duration of therapy is based on clinical response Arterial spasm kg followed by an infusion of mg kg hour for 2 hours followed by a heparin infusion3 Venous thrombosis initial dose of mg kg hour mg kg hour in neonates . and adjust based on clinical response Pharmacokinetics For absorption for coronary thrombolysis the initial response is seen in 30 minutes with a peak response in 60 minutes. Therapeutic levels are not clearly established but the recommended minimal effective plasma concentration is pg mL. For acute MI the initial response is seen in 20 to 40 minutes with concentrations ranging from to pg mL. The halflife ranges from to 7 minutes. The volume of distribution Vd is mL. Alteplase is metabolized in the liver with more than 50 of drug cleared within 5 minutes after the infusion has ended and 80 cleared within 10 minutes. Monitoring Parameters Signs and symptoms of bleeding prothrombin .
