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Anticoagulants, Plt inhibitors, Fibrinolytics

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
Created by: cburrows



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