• modified version of alteplase with longer half-life, so it can be given as a single bolus over 5-second infusion
• availability – 10 mL syringe
• indication (non-comprehensive)
  • reduce mortality associated with acute myocardial infarction

Urokinase (Abbokinase)

• used clinically as a thrombolytic agent, often referred to as a “blood clot buster” drug
• availability – in process of returning to U.S. and Canadian markets
• indications (non-comprehensive)
  • lysis of acute massive pulmonary emboli
  • lysis of pulmonary emboli accompanied by unstable hemodynamics

Streptokinase (Kabikinase, Streptase)

• converts plasminogen to plasmin, which degrades fibrin clots, fibrinogen, and other plasma proteins
• availability – supplied as a lyophilized white powder in 50 mL infusion bottles (1,500,000 IU) or in 6.5 mL vials
• indications (non-comprehensive)
  • used immediately after symptoms of a heart attack occur to improve patient survival
  • used to treat pulmonary embolism and deep venous thrombosis

Alteplase, tPA (Activase)

• tissue plasminogen activator produced by recombinant DNA
• availability - supplied as a sterile, lyophilized powder in 50 mg vials containing vacuum and in 100 mg vials without vacuum; packaged with diluent for reconstitution
• indications (non-comprehensive)
  • acute myocardial infarctions
  • unstable angina
  • pulmonary thrombosis or embolism
  • other less common conditions involving blood clots

Reteplase (Retavase)

• tissue plasminogen activator produced by recombinant DNA; usually given concomitantly with heparin and aspirin
• availability - supplied as a sterile, preservative-free, lyophilized powder in 10.4 unit vials without a vacuum, including diluent vials for reconstitution (10 mL sterile water for injection)
• indications (non-comprehensive)
  • acute myocardial infarctions
  • acute ischemic stroke
  • pulmonary embolism