What are contraindications for administering tPA?

Contraindications

• Significant head trauma or prior stroke in the previous 3 months.
• Symptoms suggest subarachnoid hemorrhage.
• Arterial puncture at a noncompressible site in previous 7 days.
• History of previous intracranial hemorrhage.
• Intracranial neoplasm, AVM, or an aneurysm.
• Recent intracranial or intraspinal surgery.

When should you not use tPA for stroke?

Any of the following should be considered disabling deficits: Complete hemianopia: ≥2 on NIHSS question 3, or. Severe aphasia: ≥2 on NIHSS question 9, or. Visual or sensory extinction: ≥1 on NIHSS question 11, or.

For which of the following patients are thrombolytic drugs contraindicated?

active bleeding or hemorrhagic disorder. previous cerebrovascular accident or active intracranial process. history of hypertension (diastolic > 110 mg Hg) GI bleeding (in the last 3 months)

Why is tPA not given after 3 hours?

Most of them are ineligible because they come to the hospital after the three-hour time window.” The timing of treatment is important, because giving a strong blood thinner like tPA during a stroke can cause bleeding inside the brain.

Why is tPA not given?

As described in table 1, the most common documented reasons for not treating with tPA were mild or rapidly improving symptoms (51%); advanced age (7%); patient or family refusal (6%); CT findings of major infarct signs, intracerebral hemorrhage, or subarachnoid hemorrhage (6%); and platelets <100,000, partial …

Is aspirin a contraindication for TPA?

However, it should be noted that pre-TPA aspirin use was not associated with an increased ICH risk in patients given the drug (16) and therefore pre-morbid aspirin use is not considered a contraindication for TPA administration in acute stroke.

What is the best medication for stroke?

An IV injection of recombinant tissue plasminogen activator (tPA) — also called alteplase (Activase) — is the gold standard treatment for ischemic stroke. An injection of tPA is usually given through a vein in the arm with the first three hours.

Is tPA a blood thinner?

It has also been used in treatment for pulmonary embolism and myocardial infarction. TPA is a blood thinner, and therefore it is not used for hemorrhagic strokes or head trauma.

Who is not eligible for tPA?

Age older than 80 years. Use of oral anticoagulants. Baseline NIH Stroke Scale score of greater than 25. History of both minor stroke and diabetes.