Retevase for STEMI

Give 1st Bolus of Reteplase
Give Heparin 20 Units/kg IV Bolus then 10 units/kg/hour (25,000 units in 250 cc D5W)
Give 2nd Bolus of Reteplase 30 minutes after 1st bolus

Retavase is administered as a two 10 unit bolus injections separated by 30 minutes.
Each bolus is administered as an intravenous injection over 2 minutes.
The second bolus is given 30 minutes after initiation of the first bolus injection.
Each bolus injection should be given via an intravenous line in which no other medication is being simultaneously injected or infused.
Heparin and Retavase® are incompatible when combined in solution. If Retavase® is to be injected through an intravenous line containing heparin, a normal saline or 5% dextrose (D5W) solution should be flushed through the line prior to and following the Retavase® injection.

Use aseptic technique throughout.
Step 1: Withdraw 10 mL of Sterile Water from the supplied vial into a sterile 10 mL syringe.
Step 2: Open the package containing the dispensing pin. Remove the protective cap from the luer lock port of the dispensing pin and connect the sterile 10mL syringe to the dispensing pin. Remove the protective flip-cap from one vial of Retavase®.
Step 3: Remove the protective cap from the spike end of the dispensing pin, and insert the spike into the vial of Retavase® until the security clips lock onto the vial. Transfer the 10 mL of SWFI through the dispensing pin into the vial of Retavase®.
Step 4: With the dispensing pin and syringe still attached to the vial, swirl the vial gently to dissolve the Retavase®. DO NOT SHAKE.
Step 5: Withdraw 10 mL of Retavase® reconstituted solution back into the syringe. A small amount of solution will remain in the vial due to overfill.
Step 6: Detach the syringe from the dispensing pin, and attach a sterile needle.
Step 7: The 10 mL bolus dose is now ready for administration. Safely discard all used reconstitution components and the empty Retavase® vial according to institutional procedures.