Ver el código de «Alteplase»

==Administration==
*Type: [[Thrombolytic]]
*Dosage Forms: powder for injection (reconstitute before use)
*Routes of Administration: IV
*Common Trade Names: tPA

==Adult Dosing==
===Acute [[MI]]===
*>67kg: 15mg IV over 1-2min; then 50mg IV over 30min; then 35mg over next 60min (i.e. 100mg over 1.5hr)
*≤67kg: 15mg IV over 1-2min; then 0.75 mg/kg (max 50mg) IV over 30 min; then 0.5 mg/kg over 60min (max 35 mg)

===Acute [[ischemic stroke]]===
*0.9mg/kg IV (max 90mg total)
**10% of dose is administered as bolus; rest is given over 60min

===Massive [[PE]]===
*100mg IV over 2hr '''OR''' 0.6mg/kg over 2min
*See also: [[EBQ:Thrombolysis in Pulmonary Embolism Metanalysis]]

===Arterial thrombosis===
*1.5 mg/hour by transcatheter intra-arterial infusion until lysis of thrombus

==Pediatric Dosing==
*[[PE]]: 0.5 mg/kg/hour IV, for a maximum of 6 hours, in addition to heparin

==Special Populations==
*[[Drug Ratings in Pregnancy|Pregnancy Rating]]: C
*[[Lactation risk categories|Lactation risk]]: Infant risk cannot be ruled out
*Renal dosing: not defined
*Hepatic dosing: not defined

==Contraindications==
*Allergy to class/drug
*Bleeding diathesis
*Active internal bleeding
*Current intracranial hemorrhage, subarachnoid hemorrhage
*Intracranial neoplasm, arteriovenous malformation, aneurysm, or other conditions that may increase the risk of intracranial bleeding
*Recent (<3 mo) intracranial or intraspinal surgery
*Recent (<3 mo) serious head trauma
*Recent (<3 mo) stroke (for patients being treated for MI or PE)
*Severe uncontrolled hypertension

==Adverse Reactions==
===Serious===
*Bleeding!
*GI bleed
*Pericardial effusion, pericarditis, cardiac tamponade
*Intracranial hemorrhage, cerebral herniation
*Stroke, seizure
*Anaphylaxis, angioedema
*Pulmonary edema, pleural effusion
*Cardiac dysrhythmia
===Common===

==Pharmacology==
*Onset of action: 30-60 minutes
*Half-life: 26.5 to 46 minutes 
*Metabolism: Liver
*Excretion: 

==Mechanism of Action==
*Tissue plasminogen activator (TPA): binds fibrin, enhances conversion of plasminogen to plasmin thus initiating fibrinolysis

==Comments==

==See Also==
*[[Thrombolytics]]
*[[Thrombolysis in Acute Ischemic Stroke (tPA)]]
*[[EBQ:Thrombolysis in Pulmonary Embolism Metanalysis]]
*[[Acute arterial ischemia]]
*[[STEMI]]

==References==
<references/>
[[Category:Pharmacology]]