Thrombolytic
Plasminogen activator
- ↑ plasmin → dissolves fibrin clots
- Thrombolysis for acute stroke, MI and massive PE
- Major bleeding, including intracranial hemorrhage, is the defining risk
- Converts plasminogen to plasmin — clot lysis
- Intracranial hemorrhage is the feared complication
- Strict time windows in stroke
Drugs with this mechanism (2)
- Alteplase — Thrombolytic for stroke and STEMI; the time window is everything.
- Tenecteplase — Single-bolus thrombolytic; increasingly first-line in stroke.
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