Tissue Plasminogen Activator

Excerpt

Tissue plasminogen activator (tPA) is classified as a serine protease (enzymes that cleave peptide bonds in proteins). It is thus one of the essential components of the dissolution of blood clots. Its primary function includes catalyzing the conversion of plasminogen to plasmin, the primary enzyme involved in dissolving blood clots. Examples of these drugs include alteplase, reteplase, and tenecteplase. Indications for the use of tPA include ischemic stroke (most common) in patients presenting to treating facility within 3 hours (4.5 hours in certain, eligible patients) after the onset of symptoms, myocardial Infarction if there would be a delay of more than 1 to 2 hours before percutaneous transluminal coronary angioplasty, pulmonary embolism in massive pulmonary embolisms, causing severe instability due to high pressure on the heart, and thrombolysis (e.g., deep vein thrombosis). This activity outlines the indications, mechanism of action, methods of administration, significant adverse effects, contraindications, toxicity, and monitoring of tPA agents so providers can direct patient therapy where they are indicated as part of the interprofessional team.