• Yuya Kobayashi, Takuya Saito, Yuichi Kawabata, Takako Igari, Yasufumi Kondo, Kanji Yamamoto, and Yoshiki Sekijima.
• Department of Neurology, Nagano Municipal Hospital, Nagano, Japan. Electronic address: juriruri@shinshu-u.ac.jp.
• J Emerg Med. 2023 Jun 1; 64 (6): 709713709-713.

BackgroundReducing the time between onset of cerebral infarction and treatment with tissue plasminogen activator improves the prognosis of patients with cerebral infarction. Diverse dosing protocols have been developed with the aim of reducing the time to bolus injection; however, only a few studies have investigated the methods and effects of the interrupted time between bolus and post-bolus infusion.ObjectiveWe evaluated the impact of the interrupted time on pharmacokinetic parameters.MethodsWe calculated the changes in alteplase concentration after a bolus injection with high precision, in relation to different interval times. Simulations were performed using the linpk package of the statistical analysis software R. Post-bolus infusion was initiated at 0-, 5-, 15-, and 30-min intervals after bolus dosing. The calculation interval was set as 6 s.ResultsAlteplase concentration rose to 1.23 mg/mL after bolus dosing. However, it dropped to 0.53 mg/mL (43.4%) during a 5-min interval, 0.27 mg/mL (22.23%) during a 15-min interval, and 0.10 mg/mL (8.38%) during a 30-min interval.ConclusionsBecause of the short half-life of alteplase, even a short delay in initiating post-bolus infusion can cause a significant reduction in serum alteplase concentration.Copyright © 2023 Elsevier Inc. All rights reserved.

18 keywords...

hide…