Drug Index

Tissue Plasminogen Activator

 
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Mechanism :

Tenecteplase binds to fibrin rich clots via the fibronectin finger-like domain and the Kringle 2 domain. The protease domain then cleaves the Arg/Val bond in plasminogen to form plasmin. Plasmin in turn degrades the fibrin matrix of the thrombus, thereby exerting its thrombolytic action.


Indication :

• Central venous thrombus

• Pulmonary artery thrombus

• Cardiac or aortic thrombus


Contraindications :

Tenecteplase is contraindicated in conditions like Coma, Trauma, Adjunct in the treatment of P. Vivax and P. Ovale malaria (eradication of liver stages), Adjunct to quinine in the treatment of P. Falciparum malaria, Adjunct to quinine in the treatment of falciparum malaria, Surgery, Bleeding diathesis, Oesophageal varices, Pain management, General dose, Resistant dermatophyte infections of skin or finger nails (not toe nails).


Dosing :

Give in the affected vessel.

Neonates: 0.1-0.5 mg/kg/hour for 3-10 hours.

Children: 0.1-0.6 mg/kg/hour for 6 hour, 20 mg in second 6 hours and 20 mg in third 6 hours.


Adverse Effect :

Bleeding.


Interaction :

Aprotinin: May antagonize the effect of Tenecteplase. Monitor for decreased effects of Tenecteplase.
Drotrecogin Alfa: Increased risk of bleeding.
Ginkgo Biloba: Additive anticoagulant/antiplatelet effects may increase bleed risk. Concomitant therapy should be avoided.
Ginseng: Increased risk of bleeding.
Ticlopidine: Increased bleeding risk. Monitor for signs of bleeding.


07/18/2019 01:55:33 Tissue Plasminogen Activator
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