Prehospital thrombolysis in MI CA

Question 1

What drugs used as anti-thombolytics in MI?

Answer 1

Tenecteplase

Question 2

What drugs used as anti-thombolytics in PE?

Answer 2

Alteplase

Question 3

MOI of tenecteplase?

Answer 3

Plasminogen activator -> plasminogen to plasmin, which degrades fibrin.

Question 4

Contraindications to thrombolysis?

Answer 4

History of ICH
Aortic Dissection
Active Bleeding
Head Trauma within 3 months

Question 5

Dose of tenecteplase?

Answer 5

30-50mg based on weight

Question 6

S/E of tenecteplase that is implicated in microcirculatory impairment?

Answer 6

Tenecteplase increases platelet activation.
Activated platelets release von Willebrand factor, various cytokines, and plasminogen-activator inhibitor, all of which may inhibit thrombolysis. Activated platelets also interact with neutrophils and endothelial cells, which may — together with increased concentrations of complement and adhesion molecules in patients with cardiac arrest — exacerbate microcirculatory impairment.