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ACTILYSE 
 
Mechanism of Action
Alteplase initiates local fibrinolysis and dissolution of clots by binding to fibrin in a thrombus and the fibrin-bound plasminogen is converted to plasmin.



Indication & Dosage
 
 
Intravenous
PULMONARY EMOBOLISM
Adult: 10 mg as bolus over 1-2 min, followed by infusion of 90 mg over 2 hr. Total dose: 100 mg but not >1.5 mg/kg for patients weighing <65 kg.
 
Intravenous
ACUTE MYOCARDIAL INFARCTION
Adult: or admin within 6 hr of MI: 15 mg as bolus, followed by 0.75 mg/kg (max: 50 mg) to be infused over 30 min, followed by the remainder dose to be infused over subsequent 60 min. For admin >6 hr after MI: 10 mg as bolus, followed by 50 mg to be infused over 60 min, then remainder dose to be infused over subsequent 2 hr. Total dose: 100 mg but not >1.5 mg/kg in patients weighing <65 kg.
 
Intravenous
ACUTE ISCHAEMIC STROKES
Adult: 0.9 mg/kg with 10% of the dose admin as a bolus over the first min, remainder dose to be infused over 60 min. To be initiated within 3 hr of the onset of symptoms. Max dose: 90 mg.
  
PrecautionsChildren, elderly. Pregnancy. Monitor intracranial haemorrhage and BP in acute stroke. Renal impairment.
  
Potentially Life-threatening 
Adverse Drug Reactions
Vomiting, bleeding from puncture sites, gingival tissues and urinary tract.
  
Adverse Drug Reactions Haemorrhage esp with previous trauma or unsuspected underlying cause of bleeding, intracerebral bleeding.
  
InteractionsHeparin reduces risk of coronary reocclusion. Prostacyclin and nitrates increase plasma alteplase clearance.
  
   
 

 

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