When such reactions occur, they usually respond to conventional therapy. These reactions are frequent sequelae of myocardial infarction and may or may not be attributable to drug therapy. If necessary, blood loss and reversal of the bleeding tendency can be managed with whole blood or packed red cells. In the event of clinically significant fibrinogen depletion, fresh frozen plasma or cryoprecipitate can be infused. It should be given via a dedicated i.v. line with an infusion pump.
Management consists of terminating the infusion at that i.v. site and application of local therapy.
Use either a polyvinyl chloride bag or glass vial and infusion set. Insert the spike end of an infusion set through the same puncture site created by the transfer device in the stopper of the vial of reconstituted alteplase. Hang the alteplase vial from the plastic molded capping attached to the bottom of the vial. The infusion of heparin should be initiated prior to the termination of the infusion of alteplase. Before beginning heparin therapy, the PTT should be obtained.