Hem-Onc - Thrombolytics

Question 1

Thrombolytics:

Answer 1

Alteplase (tPA), reteplase (rPA), tenecteplase (TNK-tPA)

Question 2

Alteplase: mech

Answer 2

Directly or indirectly aid conversion of plasminogen to plasmin, which cleaves thrombin and fibrin clots.
Increased PT, PTT
No change in platelet count

Question 3

Alteplase: uses

Answer 3

Early MI, early ischemic stroke, direct thrombolysis of severe PE

Question 4

Alteplase: tox

Answer 4

Bleeding.
Contraindicated in pts with active bleeding, hx of intracranial bleeding, recent surgery, known bleeding diatheses, or severe HTN.

Question 5

Alteplase: tox treatment

Answer 5

Treat toxicity with aminocaproic acid, an inhibitor of fibrinolysis. Fresh frozen plasma and cryoprecipitate can also be used to correct factor deficiences

Question 6

Aminocaproic acid:

Answer 6

inhibits fibrinolysis

tx overdose with thrombolytic

Question 7

Reteplase (rPA): mech

Answer 7

Directly or indirectly aids conversion of plasminogen to plasmin, which cleaves thrombin and fibrin clots.
Increases PT, PTT
No change in platelet count

Question 8

Reteplase (rPA): uses

Answer 8

Early MI, early ischemic stroke, direct thrombolysis of severe PE

Question 9

Reteplase (rPA): tox

Answer 9

Bleeding.
Contraindicated in pts with active bleeding, hx of intracranial bleeding, recent surgery, known bleeding diatheses, or severe HTN.

Question 10

Reteeplase (rPA): tox treatment

Answer 10

Aminocaproic acid, inhibits fibrinolysis

Fresh frozen plasma and cryoprecipitate can also be used to correct factor deficiencies