Available Until 9/16/2025

Planning for a Safe Transition from Alteplase to Tenecteplase for Acute Ischemic Stroke

Planned in cooperation with the ASHP Section of Medication Management Section Advisory Group of Section of Inpatient Care Practitioners 

ACPE Activity Number: 0204-0000-22-167-H05-P
Release Date: Oct 26, 2022 
Expiration Date: Oct 26, 2025 
Activity Type: Knowledge-based 
CE Credits:  1.0 contact hour, (0.10 CEU)
Activity Fee: Member – Free / Non-Member – Not Available 

This activity is a recording from a live webinar and those that claim credit for the live webinar should not claim credit for this activity.

Activity Overview 

In 2019, the AHA/ASA Guidelines for the Early Management of Patients With Acute Ischemic Stroke endorsed tenecteplase as an alterantive fibrinolytic agent to alteplase (Level IIb recommendation).  There are logistical advantages to using tenecteplase, most notably, ease of administration. While there are benefits with transitioning to tenecteplase, our institution quickly recognized medication safety barriers that would need to be addressed prior to formulary transition. Most notably, the packaging and labeling for tenecteplase, dosing calculations, EMR and automated dispensing cabinet alignment, and staff education.  The aim of this presentation is to describe the steps our institution took and the lessons learned from a complete transition in preferred formulary agent for acute ischemic stroke treatment. 


The American Society of Health-System Pharmacists is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.

This activity was planned to meet the educational needs of pharmacy preceptors. 

After completing this activity, the learner should be able to: 

  1. Identify potential safety concerns when transitioning from alteplase to tenecteplase for acute ischemic stroke. 

  1. Describe risk mitigation strategies for transitioning from alteplase to tenecteplase at each step of the medication use process. 

  1. Discuss actions that pharmacy services can take to ensure an interdisciplinary approach to implementing a safe medication distribution process. 

  • Introduction and Announcements

  • Presentation  

  • Questions, Answers, and Discussion 

Jessica Traeger, PharmD, BCCCP
Clinical Pharmacist Specialist – Neurocritical Care
University Hospitals Cleveland Medical Center
Cleveland, OH

Ashley Jones, PharmD, BCPS
Clinical Pharmacy Specialist – Emergency Medicine
University Hospitals Geauga Medical Center
Chardon, OH

Julie Fussner, BSN, RN, CPHQ, SCRN
Clinical Operations Manager
University Hospitals Neurological Institute
Cleveland, OH

Bridget Gegorski, PharmD, MS, BCSCP
Medication Safety Officer and Manager
Medication Safety and Drug Information Department
University Hospitals
Cleveland, OH

In accordance with our accreditor’s Standards of Integrity and Independence in Accredited Continuing Education, ASHP requires that all individuals in control of content disclose all financial relationships with ineligible companies. An individual has a relevant financial relationship if they have had a financial relationship with an ineligible company in any dollar amount in the past 24 months and the educational content that the individual controls is related to the business lines or products of the ineligible company. 

An ineligible company is any entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients. The presence or absence of relevant financial relationships will be disclosed to the activity audience. 

  • No one in control of the content of this activity has a relevant financial relationship (RFR) with an ineligible company. 

This activity consists of recordings of faculty slides presentations, active learning activities, discussion, and handouts. Participants must participate in the activity in its entirety to claim continuing pharmacy education credit online at ASHP Learning Center. Follow the prompts online to complete the evaluation, claim credit and view the statement of credit immediately after completing the activity. 

Per ACPE requirements, CPE credit must be claimed within 60 days of being earned. Once you have processed and claimed your CE credit, we encourage you to check your NABP eProfile account to verify your credits were transferred successfully before the ACPE 60-day deadline. It is an electronic direct-report process so your credits should appear in your account within a few minutes. After the 60 day deadline, ASHP will no longer be able to report your credit(s) for this activity.