Which is a comprehensive list of contraindications to tPA therapy?

Which is a comprehensive list of contraindications to tPA therapy?

• A. Thrombocytopenia
• B. Coagulation disorders
• C. Major surgery within the last 14 days
• D. All of the above

Answer: (D)

tPA dissolves clots by turning plasminogen into plasmin, which breaks down fibrin and can cause bleeding anywhere there’s tissue or a healing wound. Because of this, anything that increases bleeding risk is a contraindication. Thrombocytopenia reduces the body’s ability to form a platelet plug, and coagulation disorders impair the clotting cascade—both raise the risk of serious bleeding with thrombolytics. Major surgery within the last 14 days means there may be a fresh surgical site and a high risk of postoperative hemorrhage. Taken together, all of these factors are contraindications, so choosing the comprehensive option that includes them all is correct.

tPA dissolves clots by turning plasminogen into plasmin, which breaks down fibrin and can cause bleeding anywhere there’s tissue or a healing wound. Because of this, anything that increases bleeding risk is a contraindication. Thrombocytopenia reduces the body’s ability to form a platelet plug, and coagulation disorders impair the clotting cascade—both raise the risk of serious bleeding with thrombolytics. Major surgery within the last 14 days means there may be a fresh surgical site and a high risk of postoperative hemorrhage. Taken together, all of these factors are contraindications, so choosing the comprehensive option that includes them all is correct.