Name of the Procedure:

Injection, tenecteplase, 1 mg
Common Names: Tenecteplase Injection, TNK-tPA

Summary

Tenecteplase injection is a clot-dissolving medication used in the treatment of acute myocardial infarction (heart attack). Administered by injection, it helps restore blood flow to the heart by breaking down blood clots.

Purpose

Tenecteplase is used to:

• Treat acute myocardial infarction (heart attack) by dissolving blood clots in the coronary arteries.
• Improve the chances of survival and reduce heart damage when administered promptly after the onset of heart attack symptoms.

Indications

Tenecteplase injection is appropriate for patients:

• Experiencing symptoms of an acute heart attack, such as chest pain, shortness of breath, and discomfort in the upper body.
• Who have a confirmed diagnosis of a heart attack through electrocardiograms (ECG) and laboratory tests.

Preparation

• Patients should inform their healthcare provider of any allergies, pre-existing conditions, or medications they are currently taking.
• No specific fasting or medication discontinuation is typically required.
• Diagnostic assessments such as an ECG and blood tests are conducted to confirm heart attack diagnosis.

Procedure Description

1. The patient is closely monitored, and an intravenous (IV) line is established.
2. Tenecteplase is prepared and administered through the IV line at a dosage of 1 mg.
3. The administration is usually done as a single bolus injection.
4. Medical staff will continue to monitor the patient's heart function and overall condition during and after the injection.

Duration

The injection itself takes only a few minutes, but monitoring before and after the procedure can take several hours.

Setting

This procedure is typically performed in a hospital setting, often in the emergency department or intensive care unit (ICU).

Personnel

• Emergency physicians or cardiologists
• Trained nurses
• Other supporting medical staff

Risks and Complications

Common Risks:

• Bleeding, particularly at the injection site or internally. Rare Risks:
• Allergic reactions
• Stroke
• Arrhythmias (irregular heartbeats)

Management of Complications:

• Immediate medical intervention in case of bleeding, allergic reactions, or stroke symptoms.

Benefits

• Rapid clot dissolution, restoring blood flow to the heart.
• Reduced heart muscle damage and improved overall survival rates.
• Symptom relief typically within hours after administration.

Recovery

• Continuous monitoring in a hospital setting for at least 24-48 hours.
• Follow-up ECGs and blood tests to assess heart function.
• Gradual return to normal activities, with avoidance of strenuous activities initially.
• Scheduled follow-up appointments with a cardiologist.

Alternatives

• Percutaneous coronary intervention (PCI), such as angioplasty with stenting.
• Other thrombolytic agents like alteplase. Pros and Cons:
• PCI often has a higher success rate but requires specialized equipment and personnel.
• Tenecteplase is quicker and more broadly accessible in emergency settings.

Patient Experience

• Patients may feel a slight sting at the injection site but generally experience minimal discomfort during the procedure.
• Post-procedure, patients might feel fatigued or experience minor side effects like nausea.
• Pain management includes standard analgesics if needed, and medical staff will ensure patient comfort throughout the recovery process.