Alteplase

Class Thrombolytic agent
Chemistry
Recombinant protein
Routes of administration

IV or intraarterial

Absorption
Zero oral bioavailability
Solubility
pKa 6.25; good water solubility
Distribution
VOD = 0.07L/kg (effectively confined to the circulating volume); minimally protein bound
Metabolism
Metabolised by the liver, most likely by the reticuloendothelial system
Elimination
Minimal renal excretion
Time course of action
Initial half life ~ 5 minutes; eliminaton half life 72 minutes
Target receptor

Plasminogen-fibrin complex

Mechanism of action

Serum protease which has specific affinity for plasminogen in the presence of fibrin. Catalyses the conversion of plasminogen to plasmin, which degrades fibrin strands

Clinical effects

Thrombolytic effect extends into bleeding complications, which can be very serious. Anaphylaxis is not unknown, given that this is a recombinant protein

Literature reference

TGA PI document

CICM details of understanding Level 3
Mentioned around Deranged Physiology
Related SAQs

Question 4 from the first paper of 2013

Second part exam:

Question 16 from the second paper of 2015

Question 4 from the first paper of 2001