Alteplase

Alteplase Brand Names- Activase | Cathflo Activase

What is Alteplase

Alteplase is a parenteral thrombolytic agent.

Clinically, it is used for lysis of acute pulmonary thromboembolism, acute ischemic stroke, or acute coronary arterial thromboembolism associated with evolving transmural myocardial infarction.

It is also used to restore patency to an occluded intravenous catheter.

Alteplase is a recombinant form of human tissue plasminogen activator and is produced from genetically modified Chinese hamster ovary cells.

Indications

  1. acute myocardial infarction
  2. arterial thromboembolism
  3. deep venous thrombosis (DVT)
  4. intravascular catheter occlusion prophylaxis
  5. ischemic stroke
  6. occluded IV catheter
  7. percutaneous transluminal coronary angioplasty (PTCA)
  8. pleural effusion
  9. pleural empyema
  10. pulmonary embolism

For the treatment of acute myocardial infarction, including abrupt coronary occlusion during percutaneous transluminal coronary angioplasty (PTCA)

Side Effects

  1. anaphylactic shock
  2. anaphylactoid reactions
  3. angioedema
  4. AV block
  5. bleeding
  6. bradycardia
  7. cardiac arrest
  8. cardiac tamponade
  9. cerebral edema
  10. cholesterol microembolization
  11. coma
  12. ecchymosis
  13. epistaxis
  14. fever
  15. GI bleeding
  16. heart failure
  17. hypertension
  18. hypotension
  19. infection
  20. intracranial bleeding
  21. laryngeal edema
  22. livedo reticularis
  23. myocardial infarction
  24. nausea
  25. pericardial effusion
  26. pericarditis
  27. pleural effusion
  28. premature ventricular contractions (PVCs)
  29. pulmonary edema
  30. rash
  31. renal failure (unspecified)
  32. retroperitoneal bleeding
  33. rhabdomyolysis
  34. seizures
  35. stroke
  36. thromboembolism
  37. thrombosis
  38. urticaria
  39. ventricular tachycardia
  40. vomiting

Monitoring Parameters

  • creatine phosphokinase (CPK)
  • ECG
  • hemoglobin/hematocrit
  • partial thromboplastin time (PTT)
  • prothrombin time (PT)
  • thrombin time

Contraindications

  • aneurysm
  • anticoagulant therapy
  • arteriovenous malformation
  • atrial fibrillation
  • bleeding
  • brain tumor
  • breast-feeding
  • children
  • coagulopathy
  • coronary artery bypass graft surgery (CABG)
  • diabetic retinopathy
  • endocarditis
  • geriatric
  • GI bleeding
  • head trauma
  • hepatic disease
  • hypertension
  • infants
  • infection
  • intracranial bleeding
  • intracranial mass
  • intramuscular injections
  • labor
  • mitral stenosis
  • neonates
  • obstetric delivery
  • organ biopsy
  • peptic ulcer disease
  • pericarditis
  • pregnancy
  • renal disease
  • renal failure
  • seizures
  • stroke
  • surgery
  • thrombocytopenia
  • thrombophlebitis
  • thrombosis
  • trauma
  • venipuncture

Interactions

  • Abciximab
  • Acetaminophen; Aspirin, ASA; Caffeine
  • Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine
  • Acetaminophen; Caffeine; Phenyltoloxamine; Salicylamide
  • Alpha interferons
  • Altretamine
  • Aminocaproic Acid
  • Aminosalicylate sodium, Aminosalicylic acid
  • Anagrelide
  • Antimetabolites
  • Antithrombin III
  • Antithymocyte Globulin
  • Apixaban
  • Aprotinin
  • Argatroban
  • Arsenic Trioxide
  • Aspirin, ASA
  • Aspirin, ASA; Butalbital; Caffeine
  • Aspirin, ASA; Butalbital; Caffeine; Codeine
  • Aspirin, ASA; Caffeine; Dihydrocodeine
  • Aspirin, ASA; Caffeine; Orphenadrine
  • Aspirin, ASA; Carisoprodol
  • Aspirin, ASA; Carisoprodol; Codeine
  • Aspirin, ASA; Citric Acid; Sodium Bicarbonate
  • Aspirin, ASA; Dipyridamole
  • Aspirin, ASA; Omeprazole
  • Aspirin, ASA; Oxycodone
  • Aspirin, ASA; Pravastatin
  • Atropine; Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
  • Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
  • Betrixaban
  • Bexarotene
  • Bismuth Subsalicylate
  • Bismuth Subsalicylate; Metronidazole; Tetracycline
  • Bivalirudin
  • Chlorambucil
  • Choline Salicylate; Magnesium Salicylate
  • Cilostazol
  • Clofarabine
  • Clopidogrel
  • Dabigatran
  • Dalteparin
  • Danaparoid
  • Danazol
  • Defibrotide
  • Denileukin Diftitox
  • Desirudin
  • Desvenlafaxine
  • Dipyridamole
  • Drotrecogin Alfa
  • Duloxetine
  • Edoxaban
  • Enoxaparin
  • Eptifibatide
  • Estramustine
  • Fish Oil, Omega-3 Fatty Acids (Dietary Supplements)
  • Folate analogs
  • Fondaparinux
  • Garlic, Allium sativum
  • Ginger, Zingiber officinale
  • Ginkgo, Ginkgo biloba
  • Green Tea
  • Heparin
  • Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate; Sodium Biphosphate
  • Ibritumomab Tiuxetan
  • Icosapent ethyl
  • Intravenous Lipid Emulsions
  • Lepirudin
  • Levomilnacipran
  • Lomustine, CCNU
  • Magnesium Salicylate
  • Methoxsalen
  • Methylsulfonylmethane, MSM
  • Milnacipran
  • Nitroglycerin
  • Nonsteroidal antiinflammatory drugs
  • Pegaspargase
  • Pentosan
  • Photosensitizing agents (topical)
  • Platelet Inhibitors
  • Prasugrel
  • Protein C Concentrate, Human
  • Prothrombin Complex Concentrate, Human
  • Rivaroxaban
  • Salicylates
  • Salsalate
  • Selective serotonin reuptake inhibitors
  • Sodium Hyaluronate, Hyaluronic Acid
  • Sulfinpyrazone
  • Thrombin Inhibitors
  • Ticagrelor
  • Ticlopidine
  • Tinzaparin
  • Tirofiban
  • Tranexamic Acid
  • Trazodone
  • Tretinoin, ATRA
  • Venlafaxine
  • Verteporfin
  • Vilazodone
  • Vorapaxar
  • Vorinostat
  • Vortioxetine
  • Warfarin
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