If a patient receiving alteplase develops tongue swelling, what is the correct action to take based on clinical guidelines?

The development of tongue swelling in a patient receiving alteplase is indicative of a potential allergic reaction or hypersensitivity, which necessitates immediate intervention according to clinical guidelines. The appropriate course of action entails stopping the alteplase infusion to prevent further exposure to the drug, which could exacerbate the allergic reaction.

Administering methylprednisolone and diphenhydramine serves as an effective treatment strategy. Methylprednisolone, a corticosteroid, helps to reduce inflammation and manage allergic responses by modulating the immune response. Diphenhydramine, an antihistamine, alleviates symptoms associated with histamine release, such as swelling and itching. Together, these medications address the immune-mediated aspects of the reaction.

It is crucial not to administer epinephrine in this scenario because while it can be employed during anaphylactic reactions, the primary recommendation for managing drug hypersensitivity due to alteplase would primarily focus on stabilizing the inflammatory response rather than severe airway compromise that epinephrine is typically used for. Stopping alteplase and utilizing corticosteroids and antihistamines aligns better with the management of suspected drug-induced reactions like that indicated by tongue swelling.