We have no actual protocols yet but we have been looking at the use of TPA. If we have a problematic line, we initially instill urokinase for 1 hour and then reattempt use. If line continues to be problematic we instill TPA for a maximum of 3 sessions. If the line is still problematic after that we consider replacement or systemic anticoagulation whichever is most appropriate
Posts: 17 | Location: England, London | Registered: 14 April 1999
ALTEPLASE is a medication (an enzyme) which works to break up and dissolve blood clots which can block arteries. It is used in the treatment of an acute heart attack or pulmonary embolism, but now can be used to dissolve blood clots in Dialysis, PICC or Central lines. As you know, Urokinase has been taken off the market. I have literature that supports the use of this medication as an effective alternative and also a protocol for this. Alteplase (commercially packaged in 50cc or 100cc vials) is stable for 24 hours after it is mixed. Why use a 50cc vial only to waste the majority of it, when Custom Care Pharmacy is offering a unique service of unit doses (ultrafrozen) 1mg/1cc for a total volume of 2mg in a 10cc syringe at the cost of $80? The medication will be shipped on ice directly to your office, hospital or clinic. For more information, any questions, to speak with a pharmacist or to place an order, please give me a call at (800) 995-4363.
