Alteplase is the trade name for recombinant tissue plasminogen activator (r-tPA), a medication given to certain patients with ischemic stroke, pulmonary embolus, or myocardial infarction.
terminalhalf life 72 minutes
Alteplase was first approved for use in ischaemic stroke in the United States in 1996 after the results of the National Institute of Neurological Disorders and Stroke (NINDS) trial demonstrated its efficacy in improving outcomes when administered within three hours of symptom onset. This marked a significant advancement in the treatment of ischaemic stroke, establishing alteplase as a standard therapy for eligible patients.
Alteplase is another name for TPA (tissue plasminogen activator).
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.
Fibrinolytic medications, also known as thrombolytics, act on plasminogen to facilitate the breakdown of blood clots. These drugs convert plasminogen into plasmin, an enzyme that dissolves fibrin, the protein that forms the structure of clots. Common examples include alteplase, reteplase, and tenecteplase, which are often used in emergency situations such as acute myocardial infarction or ischemic stroke.
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.
Medications commonly used to dissolve and break up heart blockages include thrombolytics, such as alteplase (tPA), reteplase, and tenecteplase. These drugs work by dissolving blood clots that obstruct blood flow in the coronary arteries. Antiplatelet medications like aspirin and clopidogrel may also be prescribed to prevent further clot formation. However, the choice of treatment depends on the specific clinical situation and should be managed by a healthcare professional.
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)
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.
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.
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.
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.