Core pharmacology

Class Group

Fibrinolytic

Legacy Cicm Level

Level 3

Introduction

Recombinant tissue plasminogen activator

Presentation

modified version of alteplase with several potential advantages over alteplase, such as a longer half-life and higher fibrin specificity

Mechanism of action

It is a glycoprotein that only becomes activated when bound to thrombus bound-plasminogen. This activation then leads to the conversion of plasminogen to plasmin, which cleaves fibrin into fibrin degradation products, such d-dimers.
This mechanism of activation decreases the systemic effects

Adverse Effects Toxicity

Haemorrhage (Less than Alteplase) (cease drug, resuscitate +- tranexamic acid)
Cardiovascular- reperfusion arrhythmias and hypotension during treatment of MI
Reperfusion pain

Volume of distribution

Vd 2-4L

Metabolism

Hepatic metabolism

Excretion

Biphasic elimination
Slower renal clearance than alteplase