Dillon George M, Stevens Stacie, Dusenbury Wendy L, Massaro Lori, Toy Florence, Purdon Barbara
Michigan Neurology Associates, PC, Detroit (Dr Dillon); Virginia Commonwealth University Health, Richmond (Dr Stevens); University of Tennessee Health Science Center, Memphis (Dr Dusenbury); and Genentech, Inc., South San Francisco, California (Ms Massaro and Drs Toy and Purdon).
Adv Emerg Nurs J. 2019 Jul/Sep;41(3):271-278. doi: 10.1097/TME.0000000000000254.
Alteplase is a tissue plasminogen activator approved for treating acute ischemic stroke (AIS), acute myocardial infarction (AMI), and acute massive pulmonary embolism. Two additional tissue plasminogen activators, tenecteplase and reteplase, are also approved for AMI treatment. However, neither tenecteplase nor reteplase is approved for AIS treatment. The U.S. Food and Drug Administration has received reports of accidental administration of tenecteplase or reteplase instead of alteplase in patients with AIS, which can lead to potential overdose. Primary factors contributing to medication errors include use of the abbreviations "TPA," "tPA," or "TNK" in written or verbal orders and use of these agents in similar settings. Steps to reduce the likelihood of accidental substitution include use of full brand or generic names and inclusion of the indication in written and verbal orders, addition of alerts in automated dispensing machines and ordering systems, and use of stroke boxes containing alteplase and materials for administration.
阿替普酶是一种组织纤溶酶原激活剂，被批准用于治疗急性缺血性卒中（AIS）、急性心肌梗死（AMI）和急性大面积肺栓塞。另外两种组织纤溶酶原激活剂，替奈普酶和瑞替普酶，也被批准用于AMI治疗。然而，替奈普酶和瑞替普酶均未被批准用于AIS治疗。美国食品药品监督管理局已收到关于AIS患者意外使用替奈普酶或瑞替普酶而非阿替普酶的报告，这可能导致潜在的用药过量。导致用药错误的主要因素包括在书面或口头医嘱中使用缩写“TPA”“tPA”或“TNK”，以及在类似情况下使用这些药物。减少意外替换可能性的措施包括使用完整的品牌名或通用名，并在书面和口头医嘱中注明适应证，在自动发药机和医嘱系统中添加警示，以及使用装有阿替普酶和给药材料的卒中专用箱。
