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ALTEPLASE

Pharmacological action

Thrombolytic agent. In the bloodstream remains inactive until it combines with fibrin, to which has a high affinity; then stimulates the transition of fibrin associated plasminogen to active plasmin. It acts directly on the fibrin clot and promotes its dissolution. Influence on components of fibrinolytic blood system is insignificant. Possesses low antigenic activity.


How to use

For adults alteplase dosage:

should be administered as soon as possible after the thrombosis occurs.

 In case of acute myocardial infarction, if 6 hours have elapsed since the onset of symptoms, first 15 mg of alteplase should be administered in/in boluso, then during the first 30 minutes in/in drip - 50 mg, then continue infusion and 35 mg should be administered for 1 hour. In patients with body weight <65 kg after the bolus injection of 15 mg and 30-minute infusion in a dose of 0.75 mg/kg (not more than 50 mg) continue infusion in a drip of 0.5 mg/kg (not more than 35 mg) for 1 hour.

 If treatment is started within 6-12 h after the onset of myocardial infarction symptoms, first 10 mg of alteplase shall be given in/in bolusly, then 50 mg shall be administered in/in drip for 1 h, after which infusion shall continue at a rate of 10 mg in 30 min up to a maximum dose of 100 mg in 3 hours. In patients with body weight <65 kg the total dose should not exceed 1.5 mg/kg.

 In pulmonary embolism, 10 mg of alteplase is usually administered in/in painfully for 1-2 min, then 90 mg in/in drip for 2 h. The total dose is 100 mg in 2 hours. In patients with body weight >65 kg, the total dose should not exceed 1.5 mg/kg.https://www.accessdata.fda.gov/drugsatfda_docs/nda/96/alteplase_toc.cfm

 Treatment in case alteplase of ischemic stroke should be started within 3 hours from the onset of symptoms; usually alteplase should be administered in a dose of 0.9 mg/kg (no more than 90 mg) in a drip for 1 hour, with 10% of the total dose administered at the beginning of infusion in a painful manner. https://reference.medscape.com/drug/activase-tpa-alteplase-342287
The maximum dose of alteplase is 100 mg.

Readings alteplase overdose .

- Thrombolytic therapy of acute myocardial infarction (in the first 6-12 hours from the beginning of the disease).

- Thrombolytic therapy of ischemic stroke in the acute period (after exclusion of intracranial bleeding).

- Thrombolytic therapy for acute thromboembolism (including thromboembolism of the pulmonary artery).