Thrombolytic agents

Question 1

MOA: Fibrinolytic drugs (aka thrombolytic drugs) catalise the conversion of plasminogen to plasmin, which acts to dissolve fibrinous clots and re-cancalise occluded vessels

Answer 1

Alteplase, Tenectaplase

Question 2

In acute ischaemic stroke, Alteplase increases the chance of living independantly if it is given with ________ hours of the onset of a stroke

Answer 2

4.5

Question 3

Indications:
- acute ischaemic stroke (ideally within 4.5 hours)
- ST elevation ACS (if PCI unavailable)
- For massive PE with haemodynamic instability

Answer 3

Alteplase, Tenectaplase

Question 4

Prior to thrombolysis, intracranial haemorrhage must be excluded with a _______ before treatment

Answer 4

CT scan

Question 5

What is the major side effect associated with thrombolysis?

Answer 5

Major bleeding
- 5% have major bleeds that require transfusion
- 1-2% have intracranial bleeds

Question 6

If PCI cannot be obtained for a STEMI within 2 hours, what backup therapeutic agent should be administered?

Answer 6

Fibrinolytics/thrombolysis (Alteplase, Tenectaplase)