Implementation of Tenecteplase for Acute Ischemic Stroke Treatment

IF 1.8 4区医学 Q2 EMERGENCY MEDICINE Journal of Emergency Nursing Pub Date : 2024-03-01 DOI:10.1016/j.jen.2023.11.004

Caitlin S. Brown PharmD, BCCCP, FCCM, Francis C. Manuel PharmD, BCPS, Alicia E. Mattson PharmD, BCCCP, Cassandra J. Schmitt PharmD, Jodi D. Hellickson APRN, CNS, MS, Sarah L. Clark PharmD, BCPS, Erin D. Wieruszewski PharmD, BCCCP

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Abstract

Introduction

Acute ischemic stroke is a neurologic emergency, requiring rapid recognition and treatment with intravenous thrombolysis. Since the publication of the 2019 American Heart Association/American Stroke Association Guidelines that recommend tenecteplase as an alternative agent, several centers across the United States are transitioning from alteplase to tenecteplase as the agent of choice for thrombolysis in acute ischemic stroke.

Methods

Our health system transitioned to tenecteplase for the treatment of acute ischemic stroke in 2021 due to increasing evidence for efficacy and potential for improved door-to-needle time. Herein we describe our experience and provide guidance for other institutions to implement this change.

Conclusion

Emergency nurses are vital to the care of acute ischemic stroke patients. There are several pharmacologic and logistical differences between alteplase and tenecteplase for this indication. This paper outlines these key differences.

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实施特奈普酶治疗急性缺血性脑卒中

导言急性缺血性卒中是一种神经系统急症，需要快速识别并进行静脉溶栓治疗。自 2019 年美国心脏协会/美国卒中协会指南发布后，推荐使用替奈替普酶作为替代药物，美国多家中心正在从阿替普酶过渡到替奈替普酶，将其作为急性缺血性卒中溶栓治疗的首选药物。方法由于越来越多的证据表明替奈替普酶具有疗效，并且有可能改善从门诊到进针的时间，我们的医疗系统于 2021 年过渡到替奈替普酶治疗急性缺血性卒中。结论急诊护士对急性缺血性卒中患者的护理至关重要。阿替普酶和替奈替普酶在这一适应症的药理和后勤方面存在一些差异。本文概述了这些主要差异。

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来源期刊

Journal of Emergency Nursing 医学-护理

CiteScore

3.10

自引率

11.80%

发文量

132

审稿时长

46 days

期刊介绍： The Journal of Emergency Nursing, the official journal of the Emergency Nurses Association (ENA), is committed to the dissemination of high quality, peer-reviewed manuscripts relevant to all areas of emergency nursing practice across the lifespan. Journal content includes clinical topics, integrative or systematic literature reviews, research, and practice improvement initiatives that provide emergency nurses globally with implications for translation of new knowledge into practice. The Journal also includes focused sections such as case studies, pharmacology/toxicology, injury prevention, trauma, triage, quality and safety, pediatrics and geriatrics. The Journal aims to mirror the goal of ENA to promote: community, governance and leadership, knowledge, quality and safety, and advocacy.