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Fibrinolytics
Anticoagulants, Plt inhibitors, Fibrinolytics
Question | Answer |
---|---|
fibrinolytics | lyse formed clots by dissolving fibrin; tPA (alteplase), ; do not prevent clots; act by activating plasminogen to form active plasmin |
tPA (alteplase) (human/recombinant tissue plasminogen activator) (selective, non-antigenic since its human in origin) | converts plasminogen (inactive) to plasmin (active), site-specific for plasminogen only when bound to fibrin clot, bind to newly formed thrombus with high affinity b/c its specific to new formed clots, used to open blocked coronary arteries&dissolve clot |
plasmin active form | dissolves fibrin, clot dissolves, plt break apart into circulation |
plasminogen inactive PRO | produced in liver, built into plt plug sits there until clot is no longer needed then plasminogen will activate |
Cons with tPA | systemic lysis of other clots and bleeding |
Do not use tPA with pts w/recent strokes why? | tPA will open up clot = bleeding; use caution |
other plasminogen activators | streptokinase, tenecteplase, reteplase |
streptokinase plasminogen activator, fibrinolytic | protein, bacterial origin (beta-hemolytic streptococci), powerful, antigenic, non-specific; used for ST-elevation MI, pulmonary embolism |
Tenecteplase & Reteplase plasminogen activator, fibrinolytic | modified version of tPA, longer half-life and more fibrin specific than tPA, given IV bolus |
The activation of plasminogen to plasmin is done by what? | activated by tPA |