Hematology and Oncology Book

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t-PA

Aka: t-PA, tPA, Alteplase, Activase
  1. See Also
    1. Thrombolytic
  2. Dose
    1. Myocardial Infarction
      1. Bolus: 15 mg IV THEN
      2. Next: 0.75 mg/kg (max 50 mg) over 30 minutes THEN
      3. Next: 0.5 mg/kg (max 35 mg) over next 60 minutes
      4. Administer adjunctive Heparin concurrently
        1. See Thrombolysis
    2. Acute Ischemic Cerebrovascular Accident
      1. Calculate total dose: 0.9 mg/kg (max 90 mg)
      2. Bolus: Give 10% total dose as IV bolus over 1 minute
      3. Next: Give remainder of total dose over 60 minutes
    3. Acute Pulmonary Embolus
      1. Dose: 100 mg IV over 2 hours
      2. Restart Heparin when PTT below twice normal
  3. Disadvantages (compared with other Thrombolytics)
    1. Cost: $1200
    2. Increased bleeding risk
      1. 3-4% greater risk of bleeding in older than age 75
    3. Re-occludes earlier than other Thrombolytics
      1. Needs Heparin concurrently and afterward
  4. Advantages (compared with other Thrombolytics)
    1. Probably reperfuses arteries earlier
    2. Superior in large, anterior Myocardial Infarctions

Alteplase (C0032143)

Definition (MSH) A proteolytic enzyme in the serine protease family found in many tissues which converts PLASMINOGEN to FIBRINOLYSIN. It has fibrin-binding activity and is immunologically different from UROKINASE-TYPE PLASMINOGEN ACTIVATOR. The primary sequence, composed of 527 amino acids, is identical in both the naturally occurring and synthetic proteases.
Definition (CHV) a kind of clot-dissolving enzyme
Definition (CHV) a kind of clot-dissolving enzyme
Definition (CHV) a kind of clot-dissolving enzyme
Definition (CHV) a kind of clot-dissolving enzyme
Definition (CHV) a kind of clot-dissolving enzyme
Definition (NCI) A recombinant therapeutic agent which is chemically identical to or similar to endogenous tissue plasminogen activator (tPA). tPA is a serine protease which converts plasminogen to plasmin, a fibrinolytic enzyme. Upon administration, alteplase increases plasmin enzymatic activity, resulting in hyperfibrinolysis and potential dissolution of a thrombus or embolism.
Definition (NCI) An enzyme made in the body that helps dissolve blood clots. A form of this enzyme is made in the laboratory to treat heart attacks, strokes, and clots in the lungs. It is also being studied in the treatment of cancer. Tissue plasminogen activator is a type of systemic thrombolytic agent.
Definition (NCI) A form of tissue plasminogen activator that is made in the laboratory. It helps dissolve blood clots and is used to treat heart attacks, strokes, and clots in the lungs. It is also being studied in the treatment of cancer. It is a type of systemic thrombolytic agent.
Definition (NCI) Tissue Plasminogen Activator isoforms 1 (562-aa, 63-kD), 2 (291-aa, frameshifted with distinct C-terminus), and 3 (516-aa, deleted Ex4) are encoded by human PLAT Gene (Peptidase S1 Family). EGF-like, fibronectin I, and kringle domains mediate fibrin, LRP1, annexin II, and cytokeratin 8 binding. TPA also binds to laminin, fibronectin, and mannose receptor. Inhibited by PAI-1, serine protease TPA is widely expressed as an active single chain, then secreted, and cleaved by plasmin, tissue kallikrein, or factor XA to a fully active disulfide linked A/B-protein; N-heavy chain and C-light chain. Important in cell migration and tissue remodeling, TPA activates (increased by fibrin or heparin) plasminogen to fibrinolytic plasmin conversion by hydrolyzing a specific Arg-Val bond. Altered activity causes hyper- or hypofibrinolysis. (from LocusLink, Swiss-Prot, OMIM, and NCI)
Definition (NCI) Tissue plasminogen activator (PLAT) is a serine protease that activates the proenzyme plasminogen to plasmin, which in turn is responsible for fibrinolytic activity. PLAT is synthesized in vascular endothelial cells as a single polypeptide chain. Proteolytic cleavage of the single chain protein at a centrally located arginine-isoleucine bond by plasmin gives rise to a 2-chain disulfide-linked form, composed of the N-terminally derived heavy chain and the C-terminal light chain.
Definition (NCI) A secreted serine protease which converts the proenzyme plasminogen to plasmin, a fibrinolytic enzyme. Tissue-type plasminogen activator is synthesized as a single chain which is cleaved by plasmin to a two chain disulfide linked protein. This enzyme plays a role in cell migration and tissue remodeling. Increased enzymatic activity causes hyperfibrinolysis, which manifests as excessive bleeding; decreased activity leads to hypofibrinolysis which can result in thrombosis or embolism. (from LocusLink)
Definition (PDQ) A recombinant therapeutic agent which is chemically identical to or similar to endogenous tissue plasminogen activator (tPA). tPA is a serine protease which converts plasminogen to plasmin, a fibrinolytic enzyme. Upon administration, recombinant tPA increases plasmin enzymatic activity, resulting in hyperfibrinolysis and potential dissolution of a thrombus or embolism. Check for "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=42033&idtype=1" active clinical trials or "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=42033&idtype=1&closed=1" closed clinical trials using this agent. ("http://nciterms.nci.nih.gov:80/NCIBrowser/ConceptReport.jsp?dictionary=NCI_Thesaurus&code=C39607" NCI Thesaurus)
Concepts Amino Acid, Peptide, or Protein (T116) , Pharmacologic Substance (T121) , Enzyme (T126)
MSH D010959
SnomedCT 391744002, 27638005, 387152000, 37411004, 108997009, 386956006, 130625007
English Alteplase, Plasminogen Activator, Tissue, Plasminogen Activator, Tissue Type, Plasminogen Activator, Tissue-Type, Tissue Activator D 44, Tissue Activator D-44, Tissue Plasminogen Activator, Tissue Type Plasminogen Activator, Tissue-Type Plasminogen Activator, T-PA - tissue plasm activator, Tissue-type plasminogen activator, rt-PA, t-PA, recombinant tissue plasminogen activator, TPA (tissue plasminogen activator), tissue plasminogen activator, tissue plasminogen activator (medication), thrombolytics tissue plasminogen activator, TTPA, Alteplase - chemical (substance), tPA (tissue plasminogen activator), alteplase, alteplase, recombinant, Tisokinase, T Plasminogen Activator, T-Plasminogen Activator, Recombinant Tissue Plasminogen Activator, Plasminogen Activator (Human Tissue-Type Protein Moiety), Tissue Plasminogen Activator [Chemical/Ingredient], Plasminogen activator tissue type, t-plasminogen activator, t-pa, tpa, tPA, Activase, r-tPA, T-PA, T-PA - tissue-type plasminogen activator, Tissue plasminogen activator, Tissue-type plasminogen activator preparation, rt-PA preparation, t-PA preparation, Alteplase (product), Alteplase (substance), Tissue plasminogen activator (substance), Tissue plasminogen activator preparation (product), Tissue plasminogen activator preparation, Alteplase - chemical, Tissue plasminogen activator preparation (substance), TPA, PLAT, ALTEPLASE, ALTEPLASE,RECOMBINANT, T-plasminogen activator, T-plasminogen activator (substance)
Swedish Vävnadsplasminogenaktivator
Spanish activador del plasminógeno - T (sustancia), activador del plasminógeno - T, Alteplase - chemical, activador del plasminógeno tisular (producto), preparado con activador del plasminógeno tisular (producto), preparado con activador del plasminógeno tisular, TPA, activador del plasminógeno hístico, activador del plasminógeno tisular (sustancia), activador del plasminógeno tisular, alteplasa (producto), alteplasa (sustancia), alteplasa, preparado de TPA, preparado de activador del plasminógeno tipo tisular, preparado de activador del plasminógeno tisular (sustancia), preparado de activador tisular del plasminógeno (sustancia), preparado de activador tisular del plasminógeno, preparado de rt-PA, preparado de t-PA, Activador de Plasminogeno Tipo Tecidual, Activador de Plasminogeno T, Activador de Tejido Plasminogeno, Alteplasa, Activador de Plasminógeno Tipo Tecidual, Activador de Plasminógeno T, Activador de Tejido Plasminógeno
Czech alteplasa, plasminogen - aktivátor tkáňového typu
Finnish Kudoksen plasminogeenin aktivaattori
Italian Attivatore del plasminogeno T, Attivatore del plasminogeno di tipo tissutale, tPA, Attivatore tissutale D-44, Attivatore del plasminogeno tissutale
Russian ALTEPLAZA, PLAZMINOGENA TKANI AKTIVATOR, PLAZMINOGENA AKTIVATOR TKANEVOGO TIPA, АЛТЕПЛАЗА, ПЛАЗМИНОГЕНА АКТИВАТОР ТКАНЕВОГО ТИПА, ПЛАЗМИНОГЕНА ТКАНИ АКТИВАТОР
Japanese プラスミノーゲン活性化物質-組織型, グルトパ注, 組織プラスミノーゲンアクチベーター, 組織プラスミノゲンアクチベーター, 組織プラスミノゲンアクチベータ, 組織型プラスミノーゲン活性化物質, アクチバシン, 組織プラスミノーゲンアクチベータ, Grtpa注, アルテプラーゼ
French tPA (tissue Plasminogen Activator), Activateur tissulaire du plasminogène, t-PA (t-Plasminogen Activator), Altéplase
Polish t-PA, Aktywator plazminogenu tkankowy, Tkankowy aktywator plazminogenu, Alteplaza
German Gewebe-Plasminogen-Aktivator, Gewebetyp-Plasminogen-Aktivator, Plasminogen-Aktivator, Gewebetyp, Alteplase, T-Plasminogen-Aktivator
Portuguese Alteplase, Ativador de Plaminogênio T, Ativador de Plasminogênio Tecidual, Ativador de Plasminogênio Tipo Tecidual
Sources
Derived from the NIH UMLS (Unified Medical Language System)


Activase (C0701942)

Concepts Amino Acid, Peptide, or Protein (T116) , Pharmacologic Substance (T121) , Enzyme (T126)
MSH D010959
French Activase
English activase, Alteplase Genentech Brand, Genentech Brand of Alteplase, Hoffmann La Roche Brand of Alteplase, Hoffmann-La Roche Brand of Alteplase, Activase
Sources
Derived from the NIH UMLS (Unified Medical Language System)


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