Question

Which factors contraindicate administering alteplase more than three hours after stroke onset?

A) Diabetes mellitus
B) Age over 80 years
C) Hypertension
D) Severe renal impairment

Answer 1

Administering alteplase, a thrombolytic agent, within 3 hours of stroke onset is crucial for patients with a thrombotic stroke. Factors that contraindicate administering alteplase after three hours include diabetes mellitus, age over 80 years, hypertension, and severe renal impairment.

Step-by-step explanation:

Administering alteplase, a thrombolytic agent, within 3 hours of stroke onset is crucial for patients with a thrombotic stroke. After this timeframe, the efficacy of alteplase decreases significantly. Several factors contraindicate administering alteplase more than three hours after stroke onset, including:

1. Diabetes mellitus: Diabetes can increase the risk of bleeding and complications associated with alteplase administration.
2. Age over 80 years: Advanced age is associated with an increased risk of intracranial hemorrhage, which can be exacerbated by alteplase.
3. Hypertension: Uncontrolled high blood pressure can increase the risk of bleeding associated with alteplase administration.
4. Severe renal impairment: Impaired kidney function can affect the metabolism and elimination of alteplase, increasing the risk of adverse effects.