What is the drug TNKase used to treat?
INDICATIONS TNKase®(Tenecteplase) is indicated for use in the reduction of mortality associated with acute myocardial infarction (AMI). Treatment should be initiated as soon as possible after the onset of AMI symptoms (see Clinical Studies). DOSAGE AND ADMINISTRATION Dosage TNKase®(Tenecteplase) is for intravenous administration only.
What is the abbreviation for TNKase?
Although the complete drug name is TNKase, healthcare professionals sometimes use the shortened abbreviation "TNK." This is problematic because "TNK" can be confused as "tPA." In fact, the abbreviation "TNK" is listed on the Institute for Safe Medication Practices (ISMP) List of Error-Prone Abbreviations, Symbols, and Dose Designations.
What is in TNKase 50 mg?
TNKase® (Tenecteplase) is supplied as a sterile, lyophilized powder in a 50 mg vial under partial vacuum. Each 50 mg vial of TNKase is packaged with one 10 mL vial of Sterile Water for Injection, USP for reconstitution, the B-D® 10 mL syringe with TwinPak™ Dual Cannula Device, and three alcohol prep pads.
Can I prescribe activase or TNKase?
Do not use the abbreviation "tPA" to prescribe Activase. Use either the brand name Activase or the generic name alteplase on written prescriptions and verbal orders. Do not use the abbreviation "TNK" to prescribe TNKase. Use either the brand name TNKase or the generic name tenecteplase on written prescriptions and verbal orders.
What is TNK used for?
What is this medicine? TENECTEPLASE (TEN neck te place) is used to dissolve blood clots that form in certain blood vessels. This medicine is used when a blood clot in a heart artery causes a heart attack. This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.
What does TNK stand for in medical terms?
To date, the only scientifically-proven and FDA-approved treatment for acute stroke is the clot-busting drug, tissue plasminogen activator (tPA). A newer clot-busting drug, tenecteplase (TNK), has chemical properties that make it a potentially safer and more effective drug for treating stroke.
What's the difference between tPA and TNK?
tNK is cheaper than tPA in many locales. tNK requires a bolus injection over five to 10 seconds rather than the infusion required to administer tPA. And clinical trials show similar results in thrombolysis.
What kind of drug is TNKase?
Tnkase is a prescription medicine used to treat the symptoms of Acute Myocardial Infarction. Tnkase may be used alone or with other medications. Tnkase belongs to a class of drugs called Thrombolytics.
How do you administer TNK?
INJECT entire contents (10 mL) into the TNKase vial, directing the diluent into the powder. Slight foaming upon reconstitution is not unusual; any large bubbles will dissipate if the product is allowed to stand undisturbed for several minutes. GENTLY SWIRL until contents are completely dissolved. DO NOT SHAKE.
Is TNKase a tPA?
TNKase® (Tenecteplase) is a tissue plasminogen activator (tPA) produced by recombinant DNA technology using an established mammalian cell line (Chinese Hamster Ovary cells).
When should I give TNK?
Currently, TNK is only given to patients from 0 to 4.5 hours after onset of ischemic stroke symptoms. That may change, however, if data from clinical trials on an extended window or use in other populations are positive.
What is TNK in cardiology?
Background—Bolus thrombolytic therapy is a simplified means of administering thrombolysis that facilitates rapid time to treatment. TNK-tissue plasminogen activator (TNK-tPA) is a highly fibrin-specific single-bolus thrombolytic agent.
How long must a stroke patient remain in the ICU post tenecteplase?
The typical length of stay for a patient in the ICU after receiving alteplase for acute ischemic stroke is 24 hours. This monitoring period is primarily to detect a conversion of the stroke from ischemic to hemorrhagic, which occurs about 6% of the time.
Do you give heparin with TNKase?
In conclusion, ASSENT-3 and ENTIRE-TIMI 23 showed that a much simpler thrombolytic regimen is feasible, permitting bolus administration of both TNKase and of adjunctive low-molecular-weight heparin.
How do you give a tenecteplase to a stroke?
Current clinical practice guidelines for stroke include intravenous tenecteplase at either dose as a second-tier option, with the 0.25 mg/kg dose recommended for large vessel occlusions, based on a phase 2 trial that demonstrated superior recanalization and improved 3-month outcome relative to alteplase.
Who manufactures TNKase?
Genentech: TNKase® (tenecteplase) - Information for Patients.
What is TNKase used for?
It helps your body produce a substance that dissolves unwanted blood clots. TNKase is used to prevent death in people who have had a heart attack (acute myocardial infarction).
What to tell your doctor before TNKase?
If possible before you receive TNKase, tell your doctor if you have a brain tumor or aneurysm, high blood pressure, hemophilia or other bleeding disorder, a history of stroke, or if you have recently had a head injury or surgery on your brain or spinal cord.
Does TNKase cause hives?
TNKase increases your risk of bleeding, which can be severe or life-threatening.
Can you take Advil after TNKase?
Ask your doctor before taking aspirin or ibuprofen ( Motrin, Advil) shortly after you have received TNKase. These medications can increase your risk of bleeding. Avoid activities that may increase your risk of bleeding or injury. Use extra care to prevent bleeding while shaving or brushing your teeth.
Can you take TNKase if you are allergic to it?
You should not be treated with TNKase if you are allergic to it, or if you have: active bleeding inside your body; a recent history of medical trauma or injury; severe or uncontrolled high blood pressure; a genetic disorder affecting the blood vessels in your brain; a brain tumor, blood vessel disorder, or aneurysm (dilated blood vessel);
What is TNKase used for?
TNKase ® (Tenecteplase) is indicated for use in the reduction of mortality associated with acute myocardial infarction (AMI). Treatment should be initiated as soon as possible after the onset of AMI symptoms (see Clinical Studies ).
What are the complications of TNKase?
The most common complication encountered during TNKase therapy is bleeding. The type of bleeding associated with thrombolytic therapy can be divided into two broad categories: Internal bleeding, involving intracranial and retroperitoneal sites, or the gastrointestinal, genitourinary, or respiratory tracts.
What is tenecteplase tPA?
General. Tenecteplase is a modified form of human tissue plasminogen activator ( tPA) that binds to fibrin and converts plasminogen to plasmin. In the presence of fibrin, in vitro studies demonstrate that Tenecteplase conversion of plasminogen to plasmin is increased relative to its conversion in the absence of fibrin.
What drugs can increase platelet function?
Anticoagulants (such as heparin and vitamin K antagonists) and drugs that alter platelet function (such as acetylsalicylic acid, dipyridamole, and GP IIb/IIIa inhibitors) may increase the risk of bleeding if administered prior to, during, or after TNKase therapy.
How long does Tenecteplase stay in plasma?
Tenecteplase was cleared from the plasma with an initial half-life of 20 to 24 minutes. The terminal phase half-life of Tenecteplase was 90 to 130 minutes. In 99 of 104 patients treated with Tenecteplase, mean plasma clearance ranged from 99 to 119 mL/min.
How long to refrigerate TNKase?
If the reconstituted TNKase is not used immediately, refrigerate the TNKase vial at 2-8°C (36-46°F) and use within 8 hours. Although the supplied syringe is compatible with a conventional needle, this syringe is designed to be used with needleless IV systems.
Does TNKase cause maternal hemorrhage?
TNKase has been shown to elicit maternal and embryo toxicity in rabbits given multiple IV administrations. In rabbits administered 0.5, 1.5, and 5.0 mg/kg/day during organogenesis, vaginal hemorrhage resulted in maternal deaths. Subsequent embryonic deaths were secondary to maternal hemorrhage and no fetal anomalies were observed. TNKase does not elicit maternal and embryo toxicity in rabbits following a single IV administration. Thus, in developmental toxicity studies conducted in rabbits, the no observable effect level (NOEL) of a single IV administration of TNKase on maternal or developmental toxicity (5 mg/kg) was approximately 7 times human exposure (based on AUC) at the dose for AMI. There are no adequate and well-controlled studies in pregnant women. TNKase should be given to pregnant women only if the potential benefits justify the potential risk to the fetus.
What is TNKase used for?
TNKase ® (Tenecteplase) is indicated for use in the reduction of mortality associated with acute myocardial infarction (AMI). Treatment should be initiated as soon as possible after the onset of AMI symptoms (see CLINICAL STUDIES ).
What are the adverse reactions to TNKase?
The most frequent adverse reaction associated with TNKase is bleeding (see WARNINGS ). Should serious bleeding occur, concomitant heparin and antiplatelet therapy should be discontinued. Death or permanent disability can occur in patients who experience stroke or serious bleeding episodes.
How many ml of TNKase in a kit?
Kit Contents: Each kit contains one 50 mg vial of TNKase, one 10 mL vial of preservative-free#N#Sterile Water for Injection, USP, one BD ® 10 mL syringe with TwinPak™ Dual Cannula Device,#N#and package insert containing full prescribing information.
How long to reconstituted TNKase?
Reconstituted TNKase should be administered as a single IV bolus over 5 seconds. 4. Because TNKase contains no antibacterial preservatives, it should be reconstituted immediately before use. If the reconstituted TNKase is not used immediately, refrigerate the TNKase vial at 2–8°C (36–46°F) and use within 8 hours.
What is tenecteplase tPA?
General. Tenecteplase is a modified form of human tissue plasminogen activator (tPA) that binds to fibrin and converts plasminogen to plasmin. In the presence of fibrin, in vitro studies demonstrate that Tenecteplase conversion of plasminogen to plasmin is increased relative to its conversion in the absence of fibrin.
What drugs can increase platelet function?
Anticoagulants (such as heparin and vitamin K antagonists) and drugs that alter platelet function (such as acetylsalicylic acid, dipyridamole, and GP IIb/IIIa inhibitors) may increase the risk of bleeding if administered prior to, during, or after TNKase therapy.
How long does Tenecteplase stay in plasma?
Tenecteplase was cleared from the plasma with an initial half-life of 20 to 24 minutes. The terminal phase half-life of Tenecteplase was 90 to 130 minutes. In 99 of 104 patients treated with Tenecteplase, mean plasma clearance ranged from 99 to 119 mL/min.
What is TNKase treated with?
Patients studied in clinical trials of TNKase were routinely treated with heparin and aspirin. During TNKase therapy, results of coagulation tests and/or measures of fibrinolytic activity may be unreliable unless specific precautions are taken to prevent in vitro artifacts.
What are the adverse reactions to TNKase?
The most frequent adverse reaction associated with TNKase is bleeding. Should serious bleeding occur, concomitant heparin and antiplatelet therapy should be discontinued. Death or permanent disability can occur in patients who experience stroke or serious bleeding episodes.
What are the complications of TNKase?
The most common complication encountered during TNKase therapy is bleeding. Should serious bleeding (not controlled by local pressure) occur, any concomitant heparin or antiplatelet agents should be discontinued immediately and treated appropriately. In clinical studies of TNKase, patients were treated with both aspirin and heparin.
Does TNKase work with aspirin?
In clinical studies of TNKase, patients were treated with both aspirin and heparin. Heparin may contribute to the bleeding risks associated with TNKase. The safety of the use of TNKase with other antiplatelet agents has not been adequately studied.
Is TNKase therapy contraindicated for AMI?
TNKase therapy in patients with AMI is contraindicated in the following situations because of an increased risk of bleeding: active internal bleeding; history of cerebrovascular accident; intracranial or intraspinal surgery, or trauma within 2 months; intracranial neoplasm, arteriovenous malformation, or aneurysm; known bleeding diathesis; and severe uncontrolled hypertension.
Can TNKase cause anaphylactoid reactions?
Anaphylactoid reactions associated with the administration of TNKase are rare and can be caused by hypersensitivity to the active substance tenecteplase or to any of the excipients. If symptoms of hypersensitivity occur, appropriate therapy should be initiated.
What is the abbreviation for TNK?
Two additional reports stated that the prescriptions were verbally ordered as "TNK.". Although the complete drug name is TNKase, healthcare professionals sometimes use the shortened abbreviation "TNK.". This is problematic because "TNK" can be confused as "tPA.".
What is the generic name for TNKase?
The generic name for Retavase is reteplase, and the generic name for TNKase is tenecteplase. Both Retavase and TNKase are indicated only for managing acute myocardial infarction, and are not FDA-approved for acute ischemic stroke or pulmonary embolism. "tPA" is the abbreviation commonly used for the drug class that encompasses all tissue ...
What does tpa stand for?
The take-away message is that "tPA" is the abbreviation for the drug class tissue plasminogen activators, which includes drug products Activase, Retavase, and TNKase. tPA does not refer to a specific product, so it should not be used to denote any particular product.
What is Activase used for?
Activase is indicated for managing acute myocardial infarction, acute ischemic stroke, and acute massive pulmonary embolism. Other tissue plasminogen activators—Retavase® and TNKase—were FDA-approved later, in 1996 and in 2000.
Why is TPA used in healthcare?
However, healthcare professionals sometimes use "tPA" to refer to Activase because it was the first tissue plasminogen activator that was approved. Because all three drugs—Activase, TNKase, and Retavase—are tissue plasminogen activators, referring to any one of these products as "tPA" may lead to confusion about the intended product.
Why remove tPA?
Remove the abbreviation "tPA" from all standardized order sets and treatment protocols to avoid confusion. Do not use the abbreviation "tPA" when publishing medical literature or clinical guidelines. I hope this information has been useful. Please share these recommendations with your colleagues. References.
Is TNK a tPA?
This is problematic because "TNK" can be confused as "tPA.". In fact, the abbreviation "TNK" is listed on the Institute for Safe Medication Practices (ISMP) List of Error-Prone Abbreviations, Symbols, and Dose Designations. Furthermore, ISMP published an article earlier this year about the confusion between Activase and TNKase.
What is TNK-tPA?
Tenecteplase (TNK-tPA) is the newest fibrinolytic agent approved by the Food and Drug Administration. Tenecteplase is a 527 amino acid glycoprotein derivative of human tissue plasminogen activator that binds to fibrin and converts plasminogen to plasmin. Tenecteplase is a fibrin specific fibrinolytic.
How long does Tenecteplase last?
Pharmacokinetics. Tenecteplase has an initial half-life of 20 to 24 minutes with a terminal half-life of 90 to 130 minutes with a mean plasma clearance ranging from 99 to 119 mL/min. The initial volume of distribution approximates plasma volume and the major route of elimination is by hepatic metabolism.
What does TNK stand for?
The abbreviation TNK is common for referring to tenecteplase, but abbreviating drug names is not best practice in medicine, and in fact "TNK" is one of the examples given on the Institute for Safe Medication Practices (ISMP) do-not-use list.
What amino acids are in TNK-tPA?
In human t-PA, the amino acids at position 296-299 are Lysine, Histidine, and two Arginines . In TNK-tPA, these amino acids have been replaced by four Alanines. This mutation is responsible for increased resistance to PAI-1 .
What is tenecteplase made of?
Tenecteplase is a tissue plasminogen activator (tPA) produced by recombinant DNA technology using an established mammalian cell line ( Chinese hamster ovary cells). Tenecteplase is a 527 amino acid glycoprotein developed by introducing the following modifications to the complementary DNA (cDNA) for natural human tPA: a substitution ...
What mutation is similar to TNK-TPA?
Here is TNK-tPA. It is very similar to t-PA, but the glycosylation occurring in Kringle 1 is manipulated. The mutation T103N means that glycosylation occurs at that point. The mutation N117E means that the high mannose sugar residue is absent at that point
Does Tenecteplase bind to plasmin?
It binds to the fibrin component of the thrombus (blood clot) and selectively converts thrombus-bound plasminogen to plasmin, which degrades the fibrin matrix of the thrombus. Tenecteplase has a higher fibrin specificity and greater resistance to inactivation by its endogenous inhibitor ( PAI-1) compared to native t-PA .
Tnkase Description
- defibrotidedefibrotide increases effects of tenecteplase by pharmacodynamic synergism. Contraindicated. Coadministration of defibrotide is contraindicated with antithrombotic/fibrinolytic drugs. Th...
- prothrombin complex concentrate, humantenecteplase, prothrombin complex concentrate, human. pharmacodynamic antagonism. Contraindicated.
Tnkase - Clinical Pharmacology
Clinical Studies
Indications and Usage For Tnkase
Contraindications
Warnings
- General
Tenecteplase is a modified form of human tissue plasminogen activator (tPA) that binds to fibrin and converts plasminogen to plasmin. In the presence of fibrin, in vitro studies demonstrate that Tenecteplase conversion of plasminogen to plasmin is increased relative to its conversion in th… - Pharmacokinetics
In patients with acute myocardial infarction (AMI), TNKase administered as a single bolus exhibits a biphasic disposition from the plasma. Tenecteplase was cleared from the plasma with an initial half-life of 20 to 24 minutes. The terminal phase half-life of Tenecteplase was 90 to 130 minutes…
Precautions
- ASSENT-2 was an international, randomized, double-blind trial that compared 30-day mortality rates in 16,949 patients assigned to receive an IV bolus dose of TNKase or an accelerated infusion of Activase® (Alteplase).1 Eligibility criteria included onset of chest pain within 6 hours of randomization and ST-segment elevation or left bundle branch block on electrocardiogram (E…
Adverse Reactions
- TNKase® (Tenecteplase) is indicated for use in the reduction of mortality associated with acute myocardial infarction (AMI). Treatment should be initiated as soon as possible after the onset of AMI symptoms (see CLINICAL STUDIES).
Tnkase Dosage and Administration
- TNKase therapy in patients with acute myocardial infarction is contraindicated in the following situations because of an increased risk of bleeding (see WARNINGS): 1. Active internal bleeding 2. History of cerebrovascular accident 3. Intracranial or intraspinal surgery or trauma within 2 months 4. Intracranial neoplasm, arteriovenous malformation, or aneurysm 5. Known bleeding di…
How Is Tnkase Supplied
- Bleeding
The most common complication encountered during TNKase therapy is bleeding. The type of bleeding associated with thrombolytic therapy can be divided into two broad categories: 1. Internal bleeding, involving intracranial and retroperitoneal sites, or the gastrointestinal, genitouri… - Thromboembolism
The use of thrombolytics can increase the risk of thrombo-embolic events in patients with high likelihood of left heart thrombus, such as patients with mitral stenosis or atrial fibrillation.