Fibrinolytic

Question 1

list 2 reversal agent for alteplase

Answer 1

1. tranexamic acid
2. aminocaproic acid

Question 2

list 3 major drug-drug interaction with alteplase

Answer 2

1. antiplatelet (esp dipyridamole & aspirin) increase the risk of bleeding
2. anticoagulant (esp warfarin & heparin) increase the risk of bleeding
3. nitroglycerin decrease drug level

Question 3

what is the role of fibrinolytic

Answer 3

breakdown fibrin crosslinking to reverse clot stabilization

Question 4

what is another name for the drug class thrombolytics

Answer 4

fibrinolytic

Question 5

list 6 adverse effect of alteplase

Answer 5

1. haemorrhage/bleeding
2. ventricular arrhythmia
3. hypotension
4. oedema
5. cholesterol embolism
6. venous thromboembolism

Question 6

name 1 pharmacological class of fibrinolytics + drug name

Answer 6

• recombinant tissue plasminogen activator
• alteplase

Question 7

what is the pharmacokinetic of alteplase

Answer 7

onset: 0.5-1hr
duration: 20-30min

Question 8

what is the MOA of alteplase

Answer 8

it is a recombinant variant of t-PA & produced by recombinant DNA technology
- different from native t-pa as drug have a longer plasma half life, making it convenient for IV dosing
- binds preferentially to clot associated plasminogen & activating plasmin at the clot