Fibrinolytic

• Trade – ALTEPLASE RECOMBINANT-TPA
• Class– Thrombolytic Agent 
• MOA – Dissolves thrombi plugs in the coronary arteries and reestablishes blood flow.
• Indication – ST segment elevation greater then 1mm in 2 or more contiguous leads, New or presumed new left bundle branch block. 
• Contraindications – ST segment depression, Cardiogenic shock, Recent major surgery, cerebrovascular disease, recent (within 10 days) GI bleeding, recent trauma, severe HTN Systolic greater then 180 diastolic greater then 110. High likely hood of left heart thrombus, acute pericarditis, severe renal or liver failure with bleeding complications, significant liver dysfunction, diabetic hemorrhagic retinopathy, septic thrombophlebitis, Patients older then 75, patients already taking Coumadin. 
• Side effects – Bleeding, intracranial hemorrhage, stroke, cardiac arrhythmias, hypotension, bruising
• Dosing

Adult 

Per medical direction.

Pedi 

Not recommended