ALTEPLASE PPT PRESENTATION

1. ALTEPLASE
BY RAKIBUL HUSSAIN
PHARM D IV YEAR

2. Introduction:
 It is a Thrombolytic agent.
 Alteplase is a tissue plasminogen activator produced by recombinant DNA
technology from humans tissue culture.
 This drugs are use to lyse thrombi /clot to reconalize occulded blood vessel


3. Why this medicine is prescribed:
 1) Heart attack caused by blood clot in the arteries of the heart (MI)
 2) Blood clot in the artery of the lung
 3) Stroke caused by a blood clot in an artery of the brain

4. Mechanism of action:
 Alteplase is a tissue plasminogen activator produced by recombinant DNA
technology.
 It enhances the conversion of plasminogen to plasmin by binding to fibrin
 Initiating fibrinolysis with limited systemic proteolysis

5. Pharmacokinetic:
 Alteplase is administered by intravenous route
 Half life: 4-8 min
 Because of shorth half life it is given as IV infusion

6. Adverse effects:
 CVS: cardiac dysrhythmia, pericardial effusion, paricardtis
 GI: Gastrointestinal hemorrhage
 Hematological: hemorrhage
 Immunologic: hypersensitivity reaction
 Neurologic: Ischemic stroke, sizure
 Respiratory: pleural effusion, pulmonary edema

7. Drug interaction
 Additive antiquagulant /antiplatelet effect may increase bleed risk
 IV nitroglycerin may decrease effect of alteplase
 Ticlopidine increase bleeding risk
 ACE inhibitor increase risk of angioedema

8. USE
 1) Acute miocardial infraction:
 in adult for the improvement of ventricular function
 Reduction of mortality associated with AMI
 2) Acute ischemic stroke:
 For improving neurological recovery and reduce risk of disability
 3) pulmonary embolism:
 Use for treatment of acute massive pulmonary embolism

9. Dose:
 1) For acute MI: For over 67kg person-15mg IV bolus, followed by 50mg IV
infusion over 30min, then 35mg IV infusion over 60min, total 100mg.
 2) Pulmonary embolism:
 50mg/hour IV over 2hour for a total dose of 100mg
 3) ischemic stroke:
 0.9mg IV /kg IV for 60min

10. Monitoring parameters:
 Monitor blood pressure
 Check bleeding
 Monitor neurologic deterioration
 Monitor hypersensitivity reaction

11. Patients counseling:
 After alteplase administration patient are at increased risk of bleeding
 Advice the patient to contact healthcare professional if they experience
symptoms with bleeding, headache or stroke.