From the Guidelines
Tenecteplase for acute ischemic stroke is administered as a single intravenous bolus, not as an infusion. The administration of tenecteplase as a bolus is a key characteristic that differentiates it from other thrombolytics like alteplase, which is given as an infusion over 60 minutes 1.
Key Points
- The standard dose of tenecteplase is 0.4 mg/kg, given as a single IV bolus 1.
- Tenecteplase is considered as an alternative to alteplase in patients with minor neurological impairment and no major intracranial occlusion 1.
- The use of tenecteplase allows for faster administration compared to alteplase, potentially leading to quicker reperfusion of the affected brain tissue.
- After administration, patients require close monitoring for potential complications such as intracranial hemorrhage 1.
Administration and Monitoring
The single bolus administration of tenecteplase is one of its main advantages in stroke treatment. It is essential to monitor patients closely after administration for at least 24 hours, with regular blood pressure control and neurological assessments performed to minimize the risk of complications 1.
From the Research
Tenecteplase Infusion for Stroke
- The duration of a tenecteplase infusion for stroke is not explicitly stated in the provided studies, as tenecteplase is typically administered as a single bolus, not an infusion 2, 3, 4, 5, 6.
- Tenecteplase has a longer half-life than alteplase, allowing for single intravenous bolus administration without the need for infusion 3, 6.
- The ease of administration of tenecteplase as a single bolus makes it a preferable agent for patients who need to be urgently transported to a comprehensive stroke center for endovascular therapy 5.
- The cumulative evidence currently favors the use of the 0.25 mg/kg dose of tenecteplase for acute ischemic stroke 3, 5.