Tenecteplase use is restricted to indications for either:

(1) STEMI, or

(2) Acute ischemic stroke with following criteria:

• • Patient has a diagnosis of acute ischemic stroke causing a clinically significant (disabling) neurological deficit and is 18 years of age or older
  • Time of symptom onset is within 4.5 hours of treatment, or >4.5 hours and <9 hours of treatment, or within 9 hours from midpoint of sleep for wake-up stroke, with advanced imaging demonstrating salvageable brain tissue and meeting additional selection criteria.
  • Recommended dose of 0.25 mg/kg (max dose: 25 mg) as a single bolus in weight-based tiered dosing or for <50kg rounded to nearest 1mg
  • No contraindications to thrombolytic therapy are present

Tenecteplase is non-formulary for treatment of pulmonary embolism; alteplase is available on formulary.

Eligibility for IV Treatment with a Thrombolytic for Stroke: See Policy 900.5007

Nursing management of stroke in ED: See Policy 905.5002

Code Stroke for Adult Admitted Patients: See Policy 900.6522

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