EMed

Stroke CUH

Background

  • CUH has the biggest inpatient stroke service in Ireland
  • It is one of two thrombectomy centres in the country
  • Your role is to recognise acute stroke patients that may be suitable for acute intervention
  • The Stroke Reg is in-house every day until 8pm and a Consultant on call 24/7. Please call them

CUH Stroke Pathway

CUH Stroke Thrombolytics

Tenecteplase

More info on TNK.

Dose

0.25 mg / kg IV bolus over 5 seconds (Max. dose 25 mg).

Calculate the total weight based dose of tenecteplase using table below.

Weight (kg) Dose (mg) Dose (mL)
40 10 2.0
42 10.5 2.1
44 11 2.2
46 11.5 2.3
48 12 2.4
50 12.5 2.5
52 13 2.6
54 13.5 2.7
56 14 2.8
58 14.5 2.9
60 15 3.0
62 15.5 3.1
64 16 3.2
66 16.5 3.3
68 17 3.4
70 17.5 3.5
Weight (kg) Dose (mg) Dose (mL)
72 18 3.6
74 18.5 3.7
76 19 3.8
78 19.5 3.9
80 20 4.0
82 20.5 4.1
84 21 4.2
86 21.5 4.3
88 22 4.4
90 22.5 4.5
92 23 4.6
94 23.5 4.7
96 24 4.8
98 24.5 4.9
100 25 5.0

Print version Tenecteplase (stroke) preparation.

Alteplase (2nd line drug)

Alteplase (stroke) dosing
Weight
(Kg)		 Total rTpa
dose (mg)		 10% bolus
(mL)		 90% IV infusion
(mL/hr)		 No. of 50mg
rt-PA vials needed
40 36 4 33 1
42 38 4 34 1
44 40 4 36 1
46 41 4 37  
48 43 4 39 1
50 45 5 40 1
52 47 5 42 1
54 49 5 44 1
56 50 5 45 2
58 52 5 47 2
60 54 5 49 2
62 56 6 50 2
64 58 6 52 2
66 59 6 53 2
68 61 6 55 2
70 63 6 57 2
72 65 6 59 2
74 67 7 60 2
76 68 7 61 2
78 70 7 63 2
80 72 7 65 2
82 74 7 67 2
84 76 8 68 2
86 77 8 69 2
88 79 8 71 2
90 81 8 73 2
92 83 8 75 2
94 85 8 77 2
96 86 9 77 2
98 88 9 79 2
100 90 9 81 2
1. Total dose: 0.9mg/kg. Max. dose is 90 mg
2. Admin. of Alteplase should be sanctioned by the physician on call for stroke
3. 10% of total dose given as IV push over 2 minutes
4. Remaining 90% of dose IV over 60 minutes via infusion pump

Content by Dr Íomhar O' Sullivan. Last review Dr ÍOS 29/06/24.