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alteplase

Alteplase

Tissue plasminogen activator (tPA) indicated for the treatment of Acute Ischemic Stroke (AIS).

Complications

Intracerebral hemorrhage risk is increased with higher doses than the recommended 100 mg of alteplase (Activase®, recombinant tissue plasminogen activator (rt-PA)) 1) in older patients, in those with anterior MI or higher Killip class, and with bolus administration (vs. infusion) 2).

When heparin was used adjunctively, higher doses were associated with a higher risk of ICH 3) ICH is thought to occur in those patients with some preexisting underlying vascular abnormality 4). Immediate coronary angioplasty is safer than rt-PA when available 5).

1)
Public Health Service. Approval of Thrombolytic Agents. FDA Drug Bull. 1988; 18:6–7
2)
Mehta SR, Eikelboom JW, Yusuf S. Risk of intracranial hemorrhage with bolus versus infusion thrombolytic therapy: a meta-analysis. Lancet. 2000; 356:449–454
3)
Tenecteplase (TNKase) for thrombolysis. Med Letter. 2000; 42:106–108
4)
DaSilva VF, Bormanis J. Intracerebral Hemorrhage After Combined Anticoagulant-Thrombolytic Therapy for Myocardial Infarction: Two Case Reports and a Short Review. Neurosurgery. 1992; 30:943–945
5)
Grines CL, Browne KF, Marco J, et al. A Comparison of Immediate Angioplasty with Thrombolytic Therapy for Acute Myocardial Infarction. N Engl J Med. 1993; 328:673–679
alteplase.txt · Last modified: 2020/02/18 10:41 by administrador