Types Of Bleeding Associated With Thrombolytic Therapy Essay example
Alteplase is a serine protease which has the property of fibrin-enhanced conversion of plasminogen to plasmin. Alteplase binds to fibrin in a thrombus and converts the entrapped plasminogen to plasmin initiating local fibrinolysis with minimal systemic effects. Alteplase is cleared rapidly from circulating plasma with an initial half-life of less than 5 minutes and the clearance is mediated primarily by the liver.
Alteplase indications include the management of acute ischemic stroke in adults for improving neurological recovery and reducing the incidence of disability. Treatment should be initiated within 3 hours after the onset of stroke symptoms, and after exclusion of intracranial hemorrhage by a cranial computerized tomography (CT) scan or other diagnostic imaging method sensitive for the presence of hemorrhage. Eligibility criteria of the NINDS protocol must be strictly adhered to. Patients should be advised of the potential risk as well as the benefits of the use of alteplase for this indication.
The most common complication encountered during therapy with alteplase is bleeding. The type of bleeding associated with thrombolytic therapy can be divided into two broad categories: 1) internal bleeding involving the gastrointestinal tract, genitourinary tract, respiratory tract, retroperitoneal or intracranial sites or 2) superficial or surface bleeding, observed mainly at invaded or disturbed sites (e.g. arterial punctures, sites of recent…