III. Mechanism

  1. Recombinant Tissue Plasminogen Activator (rt-PA)
    1. Serine protease that binds Fibrin and converts Fibrin-bound plasminogen to plasmin
    2. Plasmin breaks down both Fibrin and Fibrinogen to Fibrin
      1. Fibrin Degradation Products result, which in turn also act to inhibit Fibrin formation

IV. Dosing

  1. ST Elevation Myocardial Infarction (STEMI)
    1. Give a single IV bolus dose over 5 seconds
    2. Once reconstituted, IV solution must be used within 8 hours
    3. Weight <60 kg: 30 mg IV
    4. Weight 60 to 69 kg: 35 mg IV
    5. Weight 70 to 79 kg: 40 mg IV
    6. Weight 80 to 89 kg: 45 mg IV
    7. Weight >=90 kg: 50 mg IV

V. Safety

  1. Unknown safety in pregnancy
  2. Unknown safety in Lactation

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