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What is the half life of Alteplase?
terminalhalf life 72 minutes
What is another name for TPA tissue plasminogen activator?
Alteplase is another name for TPA (tissue plasminogen activator).
Drug names ending in -ase?
Drug names ending in "ase" may be Thrombolytic agents such as alteplase, streptokinase, reteplase, and urokinase. These drugs are used to dissolve blood clots due to coronary artery thrombi, deep vien thrombosis, and pulmonary embolism.
What is the difference between the mechanisms of action of streptokinase and tissue plasminogen activator in treating thrombosis?
Both are thrombolyltic drugs. Streptokinase binds to the active complex. It promotes the cleavage of the Arg/Val bond of plasminogen leading to the formation of plasmin. The plasmin then breaks down the matrix of the thrombus. A tissue plasminogen activator is alteplase. It binds to fibrin-rich clots and cleaves the Arg/Val bond of plasminogen to produce plasmin. The plasmin then breaks down the matrix of the thrombus.
What is an indication for thrombolytic therapy?
Criteria for Acute Thrombolytic Therapy Criteria adapted in accordance with the criteria identified in National Institute of Neurological Disorders and Stroke (NINDS) 233 tPA Stroke Study and the European Cooperative Acute Stroke Study (ECASS III) 207 Treatment Criteria  Diagnosis of ischemic stroke causing measurable neurologic deficit in a patient who is18 years of age or older  Onset of symptoms more than one hour and less than 4.5 hours before alteplase administration Exclusion Criteria Historical  History of intracranial hemorrhage  Stroke or serious head or spinal trauma in the preceding three months  Recent major surgery  Arterial puncture at a non-compressible site in the previous seven days  Any other condition that could increase the risk of hemorrhage after alteplase administration Clinical  Symptoms suggestive of subarachnoid hemorrhage  Stroke symptoms due to another non-ischemic acute neurological condition such as seizure with post-ictal Todd's paralysis or focal neurological signs due to severe hypo- or hyperglycemia  Hypertension refractory to antihypertensives such that target blood pressure <185/110 cannot be achieved Laboratory  Blood glucose concentration below 2.7 mmol/L or above 22.2 mmol/L  Elevated activated partial-thromboplastin time  International Normalized Ratio greater than 1.7  Platelet count below 100,000 per cubic millimetre CT or MRI Findings  Any hemorrhage on brain CT or MRI  CT or MRI signs of acute hemispheric infarction involving more than one-third of the middle cerebral artery territory (Alberta Stroke Program Early CT Score (ASPECTS)<5)
What is drug given to patients to prevent formation of clots?
This depends on the location and severity of the clot, among other things. If the patient has a deep vein thrombosis, they will be placed on a form of heparin in order to 'thin' the blood to prevent further growth of the clot and to prevent additional clot formation. Heparin will continue until the patient has been taking Coumadin (Warfarin) for a few days as it takes time for the therapeutic level to be reached. Once the patient is at the desired clotting time with Coumadin, the heparin will be discontinued. The clot is often left to dissolve over time and the patient continues coumadin for several months, or for the rest of their life depending on the cause of the clot and their comorbidities. If the clot needs to be removed, it can be removed surgically. If a clot needs dissolved, as with an ischemic stroke or a heart attack - clot busting drugs like alteplase can be given. Unlike heparin/coumadin, this type of drug actually breaks down the clot - and all other clots in the body.
What are the five most common drugs found in an emergency room?
Emergency rooms deal with many types of injuries and illnesses. Some of the more common medical emergencies that require drugs are cardiac arrests/arrhythmias, strokes, seizures, allergic reactions, overdoses, and traumatic injuries. The most frequently administered drugs for cardiac arrest are epinephrine and atropine, generally given for pulseless rhythms including asystole. Other emergency cardiac drugs include lidocaine, adenosine, amiodarone, calcium chloride, and sodium bicarbonate. Diazepam is the most commonly used seizure-breaking agent, however many other benzodiazepines are in use. Strokes require fibrinolytic therapy in eligible patients, and drugs such as alteplase and retaplase are the most commonly used. For serious allergic reactions (anaphylactic shock) epinephrine is usually the drug of choice. Traumatic injuries don't intrinsically require medication, as fluid loss is the most pressing concern. Most trauma patients receive large doses of fluid (saline or lactated ringers) and can occasionally require blood products. Overdoses can be tricky, as the medication required to counteract the symptoms depend on what was ingested. For heroine and opioid overdoses, naloxone is an immediate and effective antidote. For poisons ingested orally, activated charcoal is often administered. Many poisons have their own unique antidote, and compiling a list is not practical.
What medicine is used to dissolve blood clots?
Thrombolytic is the general term for the class of drugs used to dissolve blood clots. Clots (thrombi) can reduce or interrupt blood flow by blocking the vessel which can result in injury to the tissues that are deprived of the blood flow and oxygenation. This occurs sometimes in a "heart attack" when blood flow is restricted by a clot, and damage or death (infarction), of the tissue of the myocardium (heart muscle) results.A common thrombolytic agent which is used for this purpose in emergency medicine measures for conditions like blood clots in the brain (cerebral thrombosis/embolus) or a coronary artery thrombosis/embolus that is causing or threatening a myocardial infarction is called TPA. TPA stands for Tissue Plasminogen Activator (also abbreviated PLAT). It acts as an enzyme to break down blood clots. Sometimes thrombolytic agents ("clot busters"/"clot busting medicines") such as Streptokinase or Urokinase are necessary to dissolve blood clots.A related class of drugs is called anticoagulants, but rather than quickly dissolving clots like thrombolytics do, these "blood thinners," as they are sometimes called, act to prevent clot formation instead. They are used either as short term or long term medications. Examples of some of the more common anticoagulants are heparin, Coumadin, and Lovenox.Thrombolytic drugs include:tissue plasminogen activator t-PA:alteplase (Activase)reteplase (Retavase)tenecteplase (TNKase)anistreplase (Eminase)streptokinase (Kabikinase, Streptase)urokinase (Abbokinase)Among those, commonly used drugs are alteplase, reteplase and streptokinase.
What are the drugs used in myocardial infarction?
glycerate nitrate is given as soon as some one suffers from a myocardial infarction. it is give via buccal route so can be absorbed quickly and show its affect. ---- In a myocardial infarction, demand for oxygen and other substrates in a particular part of the myocardium is greater than the supply. Most often, this is caused by thrombosis in an epicardial artery, resulting in ischemia (cell injury) and, later, infarction (cell death). Infarction does not happen immediately, however, so if one gets treated in time, myocardium may be saved. There are several classes of medication that are given to people having myocardial infarctions. The first of these include oxygen, aspirin, and nitroglycerin. Heparin and Plavix are other medications that may be given immediately. Many centers have cardiac catheterization suites and those listed above may be some of the only medications given to the patient while they are having the infarction. Thrombectomy and stenting performed in the "cath lab," effectively aborting the infarction. If a "cath lab" is not available at the hospital, or within a reasonable period of time by transfer, the patient may be eligible for thrombolytics, which are medications given to help dissolve clots. There are several of these, the most common is recombinant tissue plasminogen activator (r-tPA). These medications are given by IV drip and selectively break up clots in the body. They are not specific for clots only in the heart, however, and there is significant risk of bleeding during and for a period of time after receiving these medications. Patient selection is very strict, including past history and the amount of time the patient has been experiencing the symptoms of the myocardial infarction. If r-tPA is used, it is usually followed by a heparin infusion to help prevent re-clotting in the injured vessel.
Thrombolytic therapy?
DefinitionThrombolytic therapy is the use of drugs to break up or dissolve blood clots, which are the main cause of both heart attacks and stroke.Alternative NamesTissue plasminogen activator; TPA; Alteplase; Reteplase; Tenecteplase; Activase thrombolytic agent; Clot-dissolving agents; Reperfusion therapyInformationThrombolytic medications are approved for the immediate treatment of strokeand heart attack. The most commonly used drug for thrombolytic therapy is tissue plasminogen activator (tPA), but other drugs can do the same thing.According to the American Heart Association, you have a better chance of surviving and recovering from a heart attack if you receive a thrombolytic drug within 12 hours after the heart attack starts.Ideally, you should receive thrombolytic medications within the first 90 minutes after arriving at the hospital for treatment.FOR HEART ATTACKSA blood clot can block the arteries to the heart. This can cause a heart attack, when part of the muscle dies due to a lack of oxygen being delivered by the blood.Thrombolytics work by dissolving a major clot quickly. This helps restart blood flow to the heart and helps prevent damage to the heart muscle. Thrombolytics can stop a heart attack that would otherwise be deadly.The drug restores some blood flow to the heart in most patients. However, the blood flow may not be completely normal and there may still be a small amount of muscle damaged. Additional therapy, such as cardiac catheterization or angioplasty, may be needed.Your health care provider will base the decisions about whether to give you a thrombolytic medication for a heart attack on many factors. These factors include your history of chest pain and the results of an ECG test.Other factors used to determine if you are a good candidate for thrombolytics include:AgeGenderMedical history (including your history of a previous heart attack, diabetes, low blood pressure, or increased heart rate)Generally, thrombolytics will not be given if you have:A recent head injuryBleeding problemsBleeding ulcersPregnancySurgeryTaken blood thinning medications such as CoumadinTraumaUncontrolled high blood pressureFOR STROKESMost strokes are caused when blood clots move to a blood vessel in the brain and block blood flow to that area. For such strokes (ischemic strokes), thrombolytics can be used to help dissolve the clot quickly. Giving thrombolytics within 3 hours of the first stroke symptoms can help limit stroke damage and disability.The decision to give the drug is based upon:A brain CT scan to make sure there is no bleedingA physical exam that shows a significant strokeYour medical historyAs in heart attacks, a clot-dissolving drug isn't usually given if you have one of the other medical problems listed above.Thrombolytics are not given to someone who is having a hemorrhagic stroke. They could worsen the stroke by causing increased bleeding.RISKSThere are various drugs used for thrombolytic therapy, but thrombolytics are used most often. Others drugs include:LanoteplaseReteplaseStaphylokinaseStreptokinase (SK)TenecteplaseUrokinaseHemorrhage or bleeding is the most common risk. It can be life-threatening.Minor bleeding from the gums or nose can occur in approximately 25% of people who receive the drug. Bleeding into the brain occurs approximately 1% of the time. This risk is the same for both stroke and heart attack patients.CONTACT A HEALTH CARE PROVIDER OR CALL 911Heart attacks and strokes are medical emergencies. The sooner treatment with thrombolytics begins, the better the chance for a good outcome.See also:Heart attackStrokeReferencesOcava LC. Antithrombotic and thrombolytic therapy for ischemic stroke. Clin Geriatr Med. 2006; 22(1):135-154.Adams HP Jr., del Zoppo G, Alberts MJ, Bhatt DL, Brass L, Furlan A, et al. Guidelines for the early management of adults with ischemic stroke: a guideline from the American Heart Association/American Stroke Association Stroke Council, Clinical Cardiology Council, Cardiovascular Radiology and Intervention Council and the Atherosclerotic Peripheral Vascular Disease and Quality of Care Outcomes in Research Interdisciplinary Working Groups. Stroke. 2007;38:1655-1711.Libby P, Bonow RO, Mann DL, Zipes, DP. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 8th ed. St. Louis, Mo: WB Saunders; 2007:1241-1249.
