Giving thrombolysis treatment – Alteplase
Patients admitted with stroke within four and a half hours of definite onset of symptoms who are considered suitable, should be treated with intravenous alteplase 0.9mg/kg/body weight, up to a maximum of 90mg (Grade A evidence).
Diluted with sterile water to 1mg/ml 10% of the total dose is administered as an initial intravenous bolus over 2 minutes, the remaining 90% is administered as an infusion using syringe pump over 1 hour.
The thrombolysis dosage is calculated on the patient’s weight, that is 0.9 mg/kg up to a maximum of 90 mg tPA.
To obtain an accurate weight you could:
- Use a weighing PAT slide
- Roll the trolley onto portable scales
- Transfer the patient using a weighing hoist
- Normal scales if the patient can transfer or stand safely
- Ask the patient if they know a recent weight
- Ask their next of kin if the patient is unable to speak
- Review the patient’s medical records to see if they have been weighed recently
For more detailed information on Alteplase see:
