Comments in brackets denote activities specific to MGH, or additional commentary
regarding national standards or guidelines. For example:
Activate the Stroke Team
Prior to making any medical decisions, please view our disclaimer.
It is appropriate to mix tPA prior to CT even if it is not used: See below procedure for returning tPA that is mixed but not administered.
Use the calculator for the optimal dose, and check the range by quickly estimating
the dose from the table below
Enter the Weight:
EXAMPLE: Mrs. Jones weighs 150 lbs, which equals 68 Kg. Her total dose is (68 kg * 0.9 mg/kg) 61.4 mg which is equal to 61.4 ml of a 1mg/ml solution. You withdraw 6.1 ml from the 100 ml Actiavse bottle and hand to the Neurologist. Then you withdraw and discard (100 ml- 61 ml) = 39 ml as the waste. The volume of t-PA remaining in the Activase bottle is now (61.4 ml - 6.1 ml) 55.2 ml; you set the volume to infuse at a rate of 55.2 ml/hr and start the pump. As soon as the last drop of t-PA from the bottle enters the IV tubing drip chamber, remove the alteplase bottle and spike a 100 mL bag of Normal Saline with the same tubing set-up. Continue running the pump with the original 55.2 mL over 1 hour rate until all the Normal Saline is out of the bag.
When tPA is mixed but not administered or the packaging is damaged, the reconstituted and unused tPA should be returned for pharmacy credit
Reviewed/Approved by: Rost, Natalia, M.D., M.P.H. on behalf of ASQT
Last updated: 1/16/2015
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