Alteplase(rTPA Activase)

  1. Alteplase(rTPA, Activase) Class
  2. Alteplase(rTPA, Activase) Mech
    • An enzyme that converts plasminogen to the enzyme plasmin
    • Produces a limited amount of fibrinogen in the absence of fibrin.
    • Binds to fibrin in a clot and converts the plaminogen into plasmin. Plasmin then digests the fibrin and fibrinogen causing the clot(s) to dissolve.
  3. Alteplase(rTPA, Activase) Indication
    • Acute coronary syndrome (ACS)
    • Acute ischemic stroke (CVA)
  4. Alteplase(rTPA, Activase) Contra
    • Absolute:
    • Any prior intracranial hemorrhage
    • Known structual cerebral vascular lesion
    • Known malignant intracranial neoplasm
    • Ischemic stroke within 3 months(EXCEPT acute ischemic stroke within 3hrs)
    • Suspected aortic aneurysm
    • Active bleeding or bleeding disorder(excluding menses)
    • Significant closed head or facial trauma within 3 months

    • Relative:
    • History of chronic, severe or uncontrolled hypertension
    • Severe uncontrolled hypertension on presentation(SBP>180mmHg or DPB>110mmHG)
    • History of prior ischemic stroke >3months
    • Dementia; or other known intracranial pathology not specifically covered in the contraindications
    • Traumatic or prolonged CPR(>10mins) 
    • Major surgery(<3 weeks)
    • Recent internal bleeding (within 2-4 weeks)
    • Noncompressible vascular punctures
    • Pregnancy
    • Active peptic ulcers
    • Current use of anticoagulants
  5. Alteplase(rTPA, Activase) Adverse
    • Bleeding
    • Allergic reactions and or anaphylaxis(rare)
    • Fever
    • Nausea
    • Vomiting
  6. Alteplase(rTPA, Activase) Dosage
    Adult: Total dose is 100mg. Loading dose of 15mg is administered as an IV bolus over 1-2mins. Followed with an infusion of 0.75mg/kg(up to 50mg)IV over 30mins. Then an infusion of 0.5mg/kg(up to 35mg)IV over 60mins. Infusions must be administered via pump and be carefully monitored.

    Peds: Not recommended
Card Set
Alteplase(rTPA Activase)
Alteplase(rTPA, Activase) Drug profile