Tenecteplase

What is Tenecteplase

Tenecteplase is a thrombolytic agent which may be administered as a single, rapid IV bolus for the treatment of acute myocardial infarction.

Tenecteplase is a modified form of human tissue plasminogen activator that binds to fibrin and converts plasminogen to plasmin.

Tenecteplase is produced by recombinant DNA technology from genetically modified Chinese hamster ovary cells.

Compared to alteplase, tenecteplase has a prolonged half-life, increased specificity for fibrin, and increased resistance to plasminogen activator inhibitor-1 (PAI-1). In a comparative trial with accelerated alteplase dosing (ASSENT-2), tenecteplase is associated with similar rates for 30-day mortality, combined death and non-fatal stroke, intracranial bleeding, hemorrhagic stroke, total stroke, and minor bleeding; however, the incidence of major (non-cerebral) bleeding and need for blood transfusions are lower with tenecteplase.

Brand Name

TNKase

Indications

  • acute myocardial infarction
  • coronary artery thrombosis
  • ischemic stroke
  • occluded arteriovenous (AV) cannula
  • occluded IV catheter

For the treatment of acute myocardial infarction with ST-elevation (STEMI) due to coronary artery thrombosis

Side Effects

  1. anaphylactoid reactions
  2. angioedema
  3. antibody formation
  4. arrhythmia exacerbation
  5. bleeding
  6. bradycardia
  7. cholesterol microembolization
  8. ecchymosis
  9. epistaxis
  10. fever
  11. GI bleeding
  12. hematoma
  13. hematuria
  14. hemoptysis
  15. hypertension
  16. hypotension
  17. intracranial bleeding
  18. laryngeal edema
  19. livedo reticularis
  20. myocardial infarction
  21. nausea
  22. premature ventricular contractions (PVCs)
  23. purpura
  24. rash
  25. renal failure (unspecified)
  26. retroperitoneal bleeding
  27. rhabdomyolysis
  28. stroke
  29. urticaria
  30. ventricular tachycardia
  31. vomiting

Monitoring Parameters

  • ECG
  • hemoglobin/hematocrit
  • prothrombin time (PT)

Contraindications

  • aneurysm
  • anticoagulant therapy
  • arteriovenous malformation
  • atrial fibrillation
  • bleeding
  • brain tumor
  • breast-feeding
  • cardiac arrhythmias
  • coagulopathy
  • diabetic retinopathy
  • endocarditis
  • geriatric
  • head trauma
  • hepatic disease
  • hypertension
  • infection
  • intracranial mass
  • intramuscular injections
  • labor
  • mitral stenosis
  • obstetric delivery
  • organ biopsy
  • peptic ulcer disease
  • pericarditis
  • pregnancy
  • renal disease
  • renal failure
  • spinal anesthesia
  • stroke
  • surgery
  • thrombophlebitis
  • 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
  • Nonsteroidal antiinflammatory drugs
  • Pegaspargase
  • Pentosan
  • Photosensitizing agents (topical)
  • Platelet Inhibitors
  • Prasugrel
  • 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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