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DVT Treatment – Thrombolytics

Tenecteplase (TNKase)

  • 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