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- Fibrin selective "clot specific"
which is the safest of all of them?
- -dose is wt based
- -more fibrin specific than alteplase
- -less likely to elicit serious bleeding
- CLOT BUSTERS!!
- Plasmin is a protease that digests fibrin (a fibrinolytic)
- These agents are plasminogen activators and cleave plasminogen to form plasmin
- Alteplase, reteplase, and tenecteplase require fibrin for activity and their fibrinolytic effects will be (mainly) localized to the clot
- acute STEMI
- massive PE
- thrombotic stroke
- occluded IV lines
- Must be administered as early as possible after onset of STEMI symptoms · Prehospital fibrinolysis or within 30 minutes of hospital arrival
- At least within 6 hours of onset (preferred)
- Initiate therapy within 3 hours after the onset of stroke symptoms·
- Only after the exclusion of intracranial hemorrhage by CT scan or other diagnostic imaging method
- any potential source for major bleeding
- hemorrhage (major concern) and hypersensitivity
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