A 54-year-old woman comes to the emergency department because of sharp chest pain and shortness of breath for 1 day. Her temperature is 37.8°C (100.0°F), pulse is 110/min, respirations are 30/min, and blood pressure is 86/70 mm Hg. CT angiography of the chest shows a large embolus at the right pulmonary artery. Pharmacotherapy with a tissue plasminogen activator is administered. Six hours later, she develops right-sided weakness and slurred speech. Laboratory studies show elevated prothrombin and partial thromboplastin times and normal bleeding time. A CT scan of the head shows a large, left-sided intracranial hemorrhage. Administration of which of the following is most appropriate to reverse this patient's acquired coagulopathy?

Question

Quizplus · Accepted Answer

Eductional Objective: Antifibrinolytics such as aminocaproic acid and tranexamic acid can reverse the effects of tPA by inhibiting the activation of plasminogen, thereby interfering with plasmin formation. Without plasmin, fibrin is no longer degraded and further hemorrhage can be slowed or prevented. In addition to antifibrinolytics, current guidelines also recommend administering fresh frozen plasma or cryoprecipitate in cases of bleeding due to thrombolytic therapy.

A 54-Year-Old Woman Comes to the Emergency Department Because of Sharp