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Fibrinolytic and Stroke Drugs
Pharmacotherapy Fall 2013 Exam 3
22
Pharmacology
Professional
12/01/2013

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Term
fibrinolytic agent
Definition
initiates local fibrinolysis by binding to fibrin in a thrombus and converts entrapped planminogen
Term
alteplase (t-PA)
Definition
first recombinant tissue-type plasinogen activator
Term
adverse effects of t-PA
Definition
angioedema, no allergic manifestations
Term
half-life t-PA
Definition
3-4 minutes
Term
Reteplase (r-tPA)
Definition
fibrin specific, recombinant tissue-type plasminogen activator; seemed to have more rapid onset; allows bolus dosing
Term
half-life reteplase
Definition
13-16 min
Term
tenecteplase (TNK)
Definition
third generation thrombolic agent, single bolus administrations, decreased bleeding
Term
tenecteplase half-life
Definition
20-30 minutes; 5-10 second bolus administration
Term
streptokinase (SK)
Definition
non-specific serine protease, single chain polypeptide derived from beta-hemolytic streptococcus cultures
Term
half-life strptokinase
Definition
18-80 minutes
Term
adverse events of streptokinase
Definition
bleeding, antigenic, hypotension
Term
urokinase
Definition
only FDA approved for acute PE, non-specific serine protease, major activator of fibrinolysis in the extavascular compartment
Term
half-life urokinase
Definition
6-18 minutes
Term
adverse events urokinase
Definition
bleeding at local injection site, allergic reaction
Term
clinical use of fibrinolytic agents
Definition
acute MI (STEMI/NSTEMI), acute ischemic stroke, VTE (DVT and PE)
Term
r-tPA should be administered
Definition
within 4.5 hour window of onset of symptoms, no sings of hemorrhage per CT/MRI, blood pressure parameters met, two IV lines are placed and accurate body weight has been measured
Term
Intracerebral hemorrhage managment in t-PA overdose
Definition
stop t-PA and administer reversal agent as indicated (cryoprecipitate 10 units, platelets 6-8 units)
Term
quagga
Definition
is an extinct subspecies of the plains zebra that lived in South Africa. It was long thought to be a distinct species, but recent genetic studies have shown it to be the southernmost subspecies of the plains zebra
Term
ACCP suggests against giving fibrinolytics in ischemic stroke pts
Definition
between >3 and <4.5 hours
Term
ACCP suggests NOT using fibrinolytics in ischemic stroke pts
Definition
>4.5 hours
Term
alteplase
Definition
FDA approved for ischemic stroke
Term
antiplatelet therapy
Definition
ASA (81mg daily), clopidogrel (75mg daily), dypiridamole/ASA (aggrenox 200/25 twice daily)
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