alteplase
| Uses: | acute thrombotic event, including MI, stroke, and PE |
|---|---|
| Mechanism of action | recombinant plasminogen activator - which forms plasmin, which degrades fibrin alteplase only works when bound to fibrin |
| Dose | example: 15mg bolus → 50mg over 30 min → 35mg over 60 min |
| Pharmacokinetics | Absorption Distribution Metabolism liver Elimination as free alteplase - t1/2 = 4-5 mins |
| Time course of action | |
| Adverse effects | bleeding anaphylaxis hypotension |
| Contraindications | acute pancreatitis any risk of significant bleeding e.g. intracranial haemorrhage, bleeding disorder in past 6/12, anticoagulated major surgery, trauma or procedure with risk of bleeding in last 3/12 thrombocytopenia uncontrolled hypertension (>185/110 mmHg) hypersensitivity to gentamicin...? |
Tenecteplase - similar drug in class, but given as bolus