Haematological (Recombinant Tissue Plasminogen Activator - rtPA)

Question 1

Examples of drug (rtPA)

Answer 1

• Tenecteplase

- Alteplase

Question 2

Mechanism of action (rtPA)

Answer 2

• Recombinant form of tissue plasminogen activator
• Catalyses conversion of plasminogen to plasmin
• Promotes fibrin clot lysis

Question 3

Indications (rtPA)

Answer 3

• Acute ischaemic stroke within 4.5 hours of onset
• Myocardial infarction within 12 hours of onset
• Massive pulmonary embolism

Question 4

Side effects (rtPA)

Answer 4

• Bleeding

- Allergic reaction / angiooedema (1%)

Question 5

Important pharmacokinetics/pharmacodynamics (rtPA)

Answer 5

• Bolus-infusion regimen is used for alteplase
• Tenecteplase is given as a single bolus
• Pharmacodynamic interactions with other blood thinners (antiplatelets / anticoagulants)

Question 6

Patient information (rtPA)

Answer 6

• When using thrombolytic drugs, patients should be made aware of the risk-benefit ratio, which should include reference to the rate of bleeding complications.