Description of the medicine: Alteplase (Alteplase)
Synonym: Actilize, Actilise.
The tissue activator of plasminogen is an enzyme (glycoprotein) synthesized in mammalian tissues that can convert plasminogen into plasmin (in the presence of fibrinogen) inside and on the surface of the clot.
Obtained from human cell culture.
The thrombolytic effect of alteplase (like streptokinase and urokinase) lasts about 4 hours, myocardial reperfusion is achieved in 20 min - 2 h after intravenous administration.
In comparison with other fibrinolytic drugs (in particular streptokinase), alteplase acts on the thrombus more selectively, has a short half-life (4.5 min), and does not possess antigenic properties, which makes it possible to apply it again, including in patients who previously received streptokinase .
Like other thrombolytic drugs, alteplase in therapeutic doses relatively often causes hemorrhagic complications that limit the possibility of its widespread use.
Apply alteplase for thrombolytic therapy in the first 12 hours after the onset of myocardial infarction, as well as in acute massive pulmonary embolism.
Enter intravenously. The contents of 2 bottles (0.1 g) are dissolved in aseptic conditions in 100 ml of water for injection. In the first 6 hours from the onset of myocardial infarction, 0.015 g (0.01 g in the period from 6 to 12 hours after the onset of the disease) is administered in the form of a bolus for 1-2 minutes, then infusion of 0.05 g (about 0.75 mg / Kg) for 30 minutes (60 minutes in the period from 6 to 12 hours) and the rest 0.035 g (about 0.5 mg / kg) for 60 minutes (for a period of 6 to 12 hours, 0.01 g for each 30 minutes to a total dose of 0.1 g for 3 hours). In pulmonary embolism, 0.01 g is administered as a bolus and then infusion is 0.09 g for 2 hours. After the injection is complete, heparin is started (5000 IU in the form of a bolus, then infusion 1000 IU per hour).
Precautions, possible complications and contraindications are the same as with the use of other fibrinolytic drugs (see Streptokinase).
Form release: lyophilized powder for injection solutions in bottles of 0.05 grams, complete with a solvent).