Thrombolytic Agents are CLOT BUSTERS

Thrombolytic Agents are CLOT BUSTERS.

PRIORITY POINT: If the Ghostbusters had a medication class of choice, this would be it! Thrombolytic Agents are CLOT BUSTERS. They work QUICKLY to restore circulation. As such, they increase a client’s risk for bleeding.

• Who you gonna call? Streptokinase (Streptase). Call right away! These medications must be administered within 4 to 6 hours of onset of symptoms.

• If there’s something strange in your neighborhood: Thrombolytic agents dissolve clots that have already been formed. These medications convert plasminogen to plasmin, which destroys fibrinogen and other clotting factors.

• What’s the goal? Restoration of circulation, as evidenced by relief of chest pain, and reduction of initial ST segment injury pattern as shown on ECG.

• What’s the risk? Increased bleeding. These medications should only be given while the client is closely monitored. Baseline platelet and blood counts (including aPTT, PT, and INR) should be carefully assessed. Venipunctures and SQ and IM injections should be limited.

• After the clot has left the building: Administer beta blockers to decrease myocardial oxygen consumption and reduce the incidence and severity of reperfusion arrhythmias.

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Anticoagulant Tips

In order to get the therapeutic range of warfarin, you need to know your patient's prothrombin time (PT). Normal PT varies from different persons, so after knowing the normal PT of a patient, the doctor will administer or order warfarin and he or she will check the PT every now and then to see if it reaches 1.5 to 2 times the normal because this is the therapeutic range then you will get your desired effect. The nurse's role is the check the lab values and see to it that it falls between 1.5 to 2 times the normal. If the results fall below normal then we are not reaching the therapeutic range, if it falls over the normal value then there is a risk of bleeding. Always assess your patient and be ready to administer the antidote Vitamin K as per doctor's order.