Kit Locations at HH Main: -There will be 2 tenecteplase kits in the Emergency Department, located in A and D pods pyxis. -Additionally, 2 kits will be available on the carousel in central pharmacy.
Verification Process: -Tenecteplase will be ordered through the NEURO Tenecteplase (TNKase) STROKE ALERT Orders. The order is configured with a maximum dose of 25 mg and will round to the nearest milligram.
Reconstitution of Tenecteplase: -While we prefer a pharmacist to be present at the bedside to reconstitute the tenecteplase, nursing staff may proceed with reconstitution if a pharmacist is unavailable. -See Dosing/prep sheet above for reconstitution instructions.
Pharmacist Response to Stroke Alerts: -Pharmacists should make every conscious effort to attend the stroke alert when TNK is to be administered. Our neurology team will contact pharmacy if there is a potential TNKase administration. If no pharmacist is available, the nurse will administer TNK. -See Stroke Alert Process above for pharmacist responsibilities.
Weekend/Holiday Tenecteplase Orders: -Between 7AM and 11:30AM, central pharmacy is to call the NICU ascom (7-4255) to inform the pharmacist that there is an order for TNKase. -Between 11:30AM-11:00PM, stroke alerts are covered by the ED2.
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Acute Ischemic Stroke (AIS) Considerations: Tenecteplase is the preferred fibrinolytic for AIS. [as of February 1, 2024 at Huntsville Hospital Main]
Dosing/prep sheet
Education handout
Pharmacy education PowerPoint
Stroke Alert Process
Kit Locations at HH Main:
-There will be 2 tenecteplase kits in the Emergency Department, located in A and D pods pyxis.
-Additionally, 2 kits will be available on the carousel in central pharmacy.
Verification Process:
-Tenecteplase will be ordered through the NEURO Tenecteplase (TNKase) STROKE ALERT Orders. The order is configured with a maximum dose of 25 mg and will round to the nearest milligram.
Reconstitution of Tenecteplase:
-While we prefer a pharmacist to be present at the bedside to reconstitute the tenecteplase, nursing staff may proceed with reconstitution if a pharmacist is unavailable.
-See Dosing/prep sheet above for reconstitution instructions.
Pharmacist Response to Stroke Alerts:
-Pharmacists should make every conscious effort to attend the stroke alert when TNK is to be administered. Our neurology team will contact pharmacy if there is a potential TNKase administration. If no pharmacist is available, the nurse will administer TNK.
-See Stroke Alert Process above for pharmacist responsibilities.
Weekend/Holiday Tenecteplase Orders:
-Between 7AM and 11:30AM, central pharmacy is to call the NICU ascom (7-4255) to inform the pharmacist that there is an order for TNKase.
-Between 11:30AM-11:00PM, stroke alerts are covered by the ED2.
Updated: December 2023 (AIS Indication)
Alteplase/Tenecteplase in Acute Ischemic Stroke