Progressive Care Nursing Certification (PCCN) Practice Exam

Which of the following is not a contraindication for alteplase therapy?

1. Current antibiotic use

2. Recent abdominal surgery

3. Recent gastrointestinal bleed

4. Recent intracranial bleed

The correct answer is: Current antibiotic use

Alteplase, a thrombolytic agent, is commonly used in the treatment of conditions like acute ischemic stroke, myocardial infarction, and pulmonary embolism. Understanding the contraindications for its use is crucial for patient safety. Current antibiotic use is not considered a contraindication for alteplase therapy. While certain medications can pose risks when given concurrently with thrombolytics, antibiotics do not affect the mechanism by which alteplase works or increase the hazard of bleeding in the same way that recent surgeries or bleeding events do. Therefore, patients currently receiving antibiotics can still qualify for alteplase administration, assuming other contraindications are absent. In contrast, recent abdominal surgery, recent gastrointestinal bleeding, and recent intracranial bleeding are contraindications due to the increased risk of bleeding complications associated with thrombolytic therapy. Alteplase can exacerbate these risks, leading to potentially life-threatening situations. Hence, these scenarios warrant careful consideration and often preclude the use of alteplase in clinical practice.