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Predicate | Object |
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rdf:type | |
lifeskim:mentions | |
pubmed:issue |
9
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pubmed:dateCreated |
1991-12-17
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pubmed:abstractText |
Tissue plasminogen activator (t-PA) is expected to be used for cisternal drainage in subarachnoidal hemorrhage, for dissolving of the residual hematoma after stereotactic evacuation of a cerebral hematoma, and for regional intraarterial injection therapy for occlusion of the primary cerebral artery. This is because the drug exerts a very potent and immediate dissolving-effect on a hematoma when it is locally administered. However, the solubility of t-PA is rapidly decreased at pH 5 or more. At pH 7 or more, precipitation of crystals is observed when the concentration of t-PA exceeds 20 x 10(4) IU/ml. The pH of the t-PA general-purpose solution (for intravenous injection) is adjusted at 4.6 to 4.8 because of its solubility and stability, and the osmotic pressure is also increased with an increase in concentration of t-PA. When the concentration of t-PA is 750 x 10(4) IU/ml, the osmotic ratio is 30 and the pH is 4.82. These features suggest that a locally administered t-PA solution at high concentration may induce meningeal irritation leading to headache and vomiting, and exacerbation of symptomatic cerebral vasospasm when it is used for cisternal drainage. Furthermore, the t-PA solution administered intraarterially at high concentration may induce adverse effects such as dessiocyte and echinocyte deformation of erythrocytes and the sludging phenomenon of leukocytes in the cerebral microcirculation, and a sensation of fever and pain upon injection. Therefore, the dose and method of administration of the t-PA for local intracranial use should be determined by taking into consideration its pH and osmotic pressure.(ABSTRACT TRUNCATED AT 250 WORDS)
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pubmed:language |
jpn
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pubmed:journal | |
pubmed:citationSubset |
IM
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pubmed:chemical | |
pubmed:status |
MEDLINE
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pubmed:month |
Sep
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pubmed:issn |
0301-2603
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pubmed:author | |
pubmed:issnType |
Print
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pubmed:volume |
19
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pubmed:owner |
NLM
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pubmed:authorsComplete |
Y
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pubmed:pagination |
817-23
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pubmed:dateRevised |
2006-11-15
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pubmed:meshHeading |
pubmed-meshheading:1944789-Animals,
pubmed-meshheading:1944789-Brain,
pubmed-meshheading:1944789-Dogs,
pubmed-meshheading:1944789-Hydrogen-Ion Concentration,
pubmed-meshheading:1944789-Osmotic Pressure,
pubmed-meshheading:1944789-Saline Solution, Hypertonic,
pubmed-meshheading:1944789-Tissue Plasminogen Activator
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pubmed:year |
1991
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pubmed:articleTitle |
[Intracranial administration of tissue plasminogen activator and its important factors involved concerning the pH and osmotic pressure].
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pubmed:affiliation |
Department of Neurosurgery, Hirosaki University School of Medicine, Aomori, Japan.
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pubmed:publicationType |
Journal Article,
English Abstract
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