3. clot dissolving factors

Question 1

true/false: CVD is the leading cause of death in Canada

Answer 1

true

Question 2

_______ formed from plasminogen by the proteolytic hydrolysis of tissue-specific plasminogen activator (tPA) lyses fibrin clots

Answer 2

plasmin

Question 3

is a serine protease inhibitor responsible for inactivating plasmin

Answer 3

alpha 2 anti-plasmin

Question 4

this drug is a tissue plasminogen activator produced by recombinant DNA technology. a sterile, purified glycoprotein of 527 amino acids. produced by a mammalian cell line into which the cDNA for alteplase has been genetically inserted
it works by activating plasminogen, which dissolves fibrin and breaks down the thrombus

Answer 4

Activase - Alteplase

Question 5

what conditions is Activase approved for treating

Answer 5

• acute MI or heart attacls
• acute ischemic stroke
• acute, massive pulmonary embolism

Question 6

true/false: Activase is administered by i.v. infusion

Answer 6

true

Question 7

this type of stroke occurs when the blood supply to part of the brain is interrupted or reduced, preventing brain tissue from getting oxygen and nutrients.

Answer 7

ischemic stroke

Question 8

this type of stroke is due to bleeding into the brain by the rupture of a blood vessel.

Answer 8

hemorrhagic stroke

Question 9

how long following reconstitution should Activase be used

Answer 9

8 hrs

Question 10

ture/false: all thrombolytic agents increase the risk of bleeding

Answer 10

true

Question 11

true/false: Activase is reconstituted by aseptically adding the appropriate volume of the accompanying SBWI, USP to the vial, no preservatives

Answer 11

false - should be SWI. do not use SBWI

Question 12

true/false: Activase can be shaken

Answer 12

false - should be mixed with gentle swirling and/or slow inversion. DO NOT SHAKE

Question 13

this drug is a recombinant non-glycosylated form of human tissue plasminogen activator, which has been modified to contain 357 of the 527 amino acids of the original protein. it is produced in the bacterium E.coli. has a longer half-life by 13-16 mins than Activase. it binds to fibrin with a lower affinity than Activase.

Answer 13

Retavase - Reteplase

Question 14

this medication is an extracellular metallo-enzyme produced by beta-hemolytic bacterium, streptococci (the body will build up an immunity to it). it is a cheap clot-dissolving medication for the 1st heart attack and pulmonary embolism (it should not be used again after 4 days from the first administration as it may not be effective and can cause an allergic reaction). it is used to prevent post surgical adhesions especially for abdominal surgery

Answer 14

Streptokinase (SK)

Question 15

this medication is a lyophilized formulation of anistreplase, the p-anisoyl derivative of the primary Lys-plasminogen-streptokinase activator complex

Answer 15

Eminase - Anistreplase

Question 16

this is a serine protease originally isolated in human urine (also found in the blood stream and ECM). it is synthesized as a zymogen form and is activated by proteolytic cleavage between L158 and L159. the two resulting chains are kept together by a disulphide bond. may participate in thrombolysis or extracellular matrix degradation

Answer 16

urokinase

Question 17

novel chimeric protein combines two human pro-fibrinolytic factors being formed by part of the N-terminal sequence of tissue plasminogen activator (tPA) linked to the C-terminal sequence of single chain urokinase (uPA). more potent and longer lasting compared to recombinant tPA (alteplase). one single bolus injection (iv). still in phase III clinical trials

Answer 17

amediplase (K2tu-PA)

Question 18

________ & ________ inhibits the function of plasmin

Answer 18

alpha-2 antiplasmin and alpha-2 macroglobulin

Question 19

plasminogen activator inhibitor 1&2 inhibits ___________ & ___________

Answer 19

tissue plasminogen activator (tPA) and urokinase

Question 20

________ stimulates the conversion of fibrinogen to fibrin

Answer 20

thrombin