Saturday, February, 11, 2012

Thrombolytic therapy (tissue plasminogen activator - tPA)

Table of Contents

  • Age
  • Gender
  • Medical history (including your history of a previous heart attack, diabetes, low blood pressure, or increased heart rate)

Generally, thrombolytics will not be given if you have:

  • A recent head injury
  • Bleeding problems
  • Bleeding ulcers
  • Pregnancy
  • Surgery
  • Taken blood thinning medications such as Coumadin
  • Trauma
  • Uncontrolled high blood pressure

FOR STROKES

Most strokes are caused when blood clots move to a blood vessel in the brain and block blood flow to that area. For such strokes (ischemic strokes), thrombolytics can be used to help dissolve the clot quickly. Giving thrombolytics within 3 hours of the first stroke symptoms can help limit stroke damage and disability.

The decision to give the drug is based upon:

  • A brain CT scan to make sure there is no bleeding
  • A physical exam that shows a significant stroke
  • Your medical history

As in heart attacks, a clot-dissolving drug isn't usually given if you have one of the other medical problems listed above.

Thrombolytics are not given to someone who is having a hemorrhagic stroke. They could worsen the stroke by causing increased bleeding.

RISKS

There are various drugs used for thrombolytic therapy, but thrombolytics are used most often. Others drugs include:

  • Lanoteplase
  • Reteplase
  • Staphylokinase
  • Streptokinase (SK)
  • Tenecteplase
  • Urokinase

Hemorrhage or bleeding is the most common risk. It can be life-threatening.

Minor bleeding from the gums or nose can occur in approximately 25% of people who receive the drug. Bleeding into the brain occurs approximately 1% of the time. This risk is the same for both stroke and heart attack patients.

CONTACT A HEALTH CARE PROVIDER OR CALL 911

Heart attacks and strokes are medical emergencies. The sooner treatment with thrombolytics begins, the better the chance for a good outcome.

See also:

  • Heart attack
  • Stroke

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Review Date: 06/01/2010
Reviewed By: Issam Mikati, MD, Associate Professor of Medicine, Feinberg School of Medicine, Director, Northwestern Clinic Echocardiography Lab, Northwestern University, Chicago, IL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org)