Home Drug Guide Reteplase

Drug Guide

Generic Name

Reteplase

Brand Names Retavase

Classification

Therapeutic: Thrombolytic agent

Pharmacological: Recombinant tissue plasminogen activator (tPA)

FDA Approved Indications

  • Acute myocardial infarction (MI)

Mechanism of Action

Reteplase catalyzes the conversion of plasminogen to plasmin, leading to the degradation of fibrin and dissolution of thrombi in blood vessels.

Dosage and Administration

Adult: 30 units IV bolus over 2 minutes, repeated in 30 minutes for a total dose of 60 units.

Pediatric: Not approved for pediatric use.

Geriatric: Use with caution in elderly patients, monitor closely.

Renal Impairment: No specific adjustment indicated.

Hepatic Impairment: No specific adjustment indicated.

Pharmacokinetics

Absorption: Administered intravenously, so absorption is immediate.

Distribution: Plasmatic, distributes rapidly with a large volume of distribution.

Metabolism: Metabolized by the liver and cleared via the reticuloendothelial system.

Excretion: Excreted mainly in urine as metabolites.

Half Life: Approximately 13-16 minutes.

Contraindications

  • Active bleeding or bleeding diathesis
  • History of intracranial hemorrhage
  • Recent major surgery or trauma
  • History of cerebrovascular accident (stroke) within 3 months
  • Severe uncontrolled hypertension.

Precautions

  • Use with caution in patients with recent surgery, trauma, or bleeding risk factors.
  • Monitor for signs of bleeding.
  • Ensure availability of blood products and ready access to neurosurgical consultation.

Adverse Reactions - Common

  • Bleeding at site of injection (Common)
  • Bleeding elsewhere (Common)

Adverse Reactions - Serious

  • Intracranial hemorrhage (Rare but serious)
  • Allergic reactions (Rare)

Drug-Drug Interactions

  • Anticoagulants (e.g., heparin, warfarin)
  • Antiplatelet agents (e.g., aspirin, clopidogrel)

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Assess for contraindications, baseline neurological status, and signs of bleeding.

Diagnoses:

  • Risk for bleeding
  • Ineffective tissue perfusion related to bleeding complications.

Implementation: Administer as ordered, monitor vital signs and neurological status closely, check for signs of bleeding.

Evaluation: Monitor for resolution of symptoms of MI, effectiveness of thrombolysis, and adverse effects.

Patient/Family Teaching

  • Report any signs of bleeding, unusual pain, or neurological changes immediately.
  • Avoid invasive procedures unless directed by healthcare provider.
  • Inform about the importance of follow-up care.

Special Considerations

Black Box Warnings:

  • Serious bleeding complications, including intracranial hemorrhage.
  • Use only in hospitals with facilities to manage bleeding complications.

Genetic Factors: None specified.

Lab Test Interference: May interfere with coagulation tests temporarily.

Overdose Management

Signs/Symptoms: Excessive bleeding, signs of internal or external hemorrhage.

Treatment: Discontinue drug, provide supportive care, administer blood products if necessary, and manage bleeding according to protocols.

Storage and Handling

Storage: Store refrigerated at 2-8°C, protect from light.

Stability: Stable until expiration date when properly stored.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.