Question 1

i have a negative rpr and a negative tpa at 207 days post possible exposure.  are these test results 100% conclusive at this time?  can i stop worry

Accepted Answer

Close to it: They are very good tests and the best that we have.With two negative test, you are fine but keep diligent and use common sense and condoms.

Question 2

what should be monitored before administering the tpa (alteplase)?

Accepted Answer

Complicated : You need to check it with your physician since it depends on many parameters , but generally speaking: head ct, blood pressure, age, time onset of stroke, coagulant estate and use of anticoagulation, history of previous stroke,  bleeding and recent surgeries....

Question 3

what is the age limit for being given tpa (alteplase)?

Accepted Answer

Gradient: The older one gets, the greater the risk of intracerebral hemorrhage. Especially after age 75 risk escalates. Then this turns on risk-benefit estimation.

Question 4

why don't stroke patients get tpa (alteplase) therapy?

Accepted Answer

Patients wait: The most common reason is they wait too long before presenting to hospital. Current guidelines for t-pa in most hospitals have been extended from 3to 4.5->5 hours after the onset of symptoms of a stroke. Part of the problem is many patients wake up with weakness/speech difficulties, the time of onset can't be determined, the patient is ineligible.Recent major surgery or bleeding are exclusions.

Question 5

docs, could a patient be given tpa (alteplase) when on antiplatelet therapy?

Accepted Answer

Yes: TPA (alteplase) is not contraindicated with people taking aspirin, NSAIDs or antiplatelet drugs (dipyridamole, ticlopidine, clopidogrel).  TPA (alteplase) is a contraindicated in people on warfarin whose INR is greater than 1.7.  Use of low molecular weight heparin in the past 24 hours is also a contraindication.

Question 6

how much time to hold tpa (alteplase) if a patient had stroke and is on dabigatran therapy?

Accepted Answer

No TPA (alteplase): Dabigatran is an absolute contraindication to TPA (alteplase) use. The stroke patient in question is not a candidate for TPA (alteplase).

Question 7

i finished syphilis treatment back in february and my lab results tpa and rpr still reactive titer is 1:2 but on ref range says non reactive for all. do i still needs to worry about my results? also is theres any chance that i have neurosyphilis?

Accepted Answer

: Yes

Question 8

what happens if a patient is on clopidogrel/brilinta/effient etc and have a stroke, can they receive tpa (alteplase)?

Accepted Answer

Yes: the contraindication is relative, not absolute. caution is advised.

Question 9

my dad had an ischemic stroke on thurs. & was given tpa (alteplase). he has a "minimal" bleed on his brain. does this heal itself, and what is the recovery time?

Accepted Answer

Yes, it heals: There is always healing as long as we are alive. The extent of healing and the recovery time depends mainly on characteristics of the patient and degree of injury. If your father is young and healthy or stroke is minor, relatively short recovery time. If old and sick or stroke is major, longer recovery. The blood will get slowly absorbed over weeks but this has very little to do with recovery.

Question 10

do all tia's cause brain changes on mri or ct scans? i just went through stroke sym.the er then tpa  icu no changes on mri or ct .i have   symp.again?

Accepted Answer

TIA may: cause MRI changes if scanned early(CT typically will be normal). These changes tend to resolve, as TIA(Transient Ischemic Attack) causes no permanent damage.

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Doctor answers about:

Tpa medication

A member asked:

I have a negative rpr and a negative tpa at 207 days post possible exposure. are these test results 100% conclusive at this time? can i stop worry

A member asked:

What should be monitored before administering the tpa (alteplase)?

A member asked:

What is the age limit for being given tpa (alteplase)?

A member asked:

Why don't stroke patients get tpa (alteplase) therapy?

A member asked:

Docs, could a patient be given tpa (alteplase) when on antiplatelet therapy?

A member asked:

How much time to hold tpa (alteplase) if a patient had stroke and is on dabigatran therapy?

A member asked:

I finished syphilis treatment back in february and my lab results tpa and rpr still reactive titer is 1:2 but on ref range says non reactive for all. do i still needs to worry about my results? also is theres any chance that i have neurosyphilis?

A member asked:

What happens if a patient is on clopidogrel/brilinta/effient etc and have a stroke, can they receive tpa (alteplase)?

A member asked:

My dad had an ischemic stroke on thurs. & was given tpa (alteplase). he has a "minimal" bleed on his brain. does this heal itself, and what is the recovery time?

A member asked:

Do all tia's cause brain changes on mri or ct scans? i just went through stroke sym.the er then tpa icu no changes on mri or ct .i have symp.again?

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