| Alteplase and tenecteplase: applications in the peripheral circulation. | |
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MedLine Citation:
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PMID: 11981795 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Alteplase (t-PA), a recombinant analogue of human tissue plasminogen activator, became the first genetically engineered thrombolytic approved by the Food and Drug Administration in 1987 for acute myocardial infarction (AMI). In addition to AMI, alteplase is currently approved for the treatment of acute ischemic stroke and pulmonary embolism, and we anticipate approval for catheter clearance in late 2001 in a 2-mg vial configuration. With the withdrawal of human neonatal kidney cell-derived urokinase, alteplase has become an alternative agent in peripheral vascular applications. Because few interventionalists had prior experience with the handling and dosage of alteplase, the Advisory Panel to the Society of Cardiovascular and Interventional Radiology established practice guidelines for use in noncoronary applications. Emerging clinical experience with contemporary dosing regimens shows a safety and efficacy profile similar to urokinase but with significantly reduced drug costs. Tenecteplase (TNK) is a genetically modified version of alteplase. TNK is the only plasminogen activator available that has shown a significantly enhanced safety profile versus alteplase in AMI. Approved for a 5-second, single-bolus injection in AMI, TNK possesses a longer half-life, increased resistance to plasminogen activator inhibitor, and improved fibrin specificity compared with alteplase. Because of its enhanced safety profile, TNK may be a desirable agent for peripheral vascular applications. Initial clinical studies with TNK in acute arterial and venous disease are ongoing. This article outlines the Advisory Panel guidelines for using alteplase and highlights features of tenecteplase. |
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Authors:
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C P Semba; K Sugimoto; M K Razavi; |
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Publication Detail:
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Type: Guideline; Journal Article; Practice Guideline; Review |
Journal Detail:
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Title: Techniques in vascular and interventional radiology Volume: 4 ISSN: 1089-2516 ISO Abbreviation: Tech Vasc Interv Radiol Publication Date: 2001 Jun |
Date Detail:
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Created Date: 2002-04-30 Completed Date: 2002-06-07 Revised Date: 2008-11-21 |
Medline Journal Info:
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Nlm Unique ID: 9806675 Medline TA: Tech Vasc Interv Radiol Country: United States |
Other Details:
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Languages: eng Pagination: 99-106 Citation Subset: IM |
Copyright Information:
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Copyright 2001 by W.B. Saunders Company |
Affiliation:
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Cardiovascular Clinical Research, Genentech Inc., MS 59, 1 DNA Way, South San Francisco, CA 94080-4990, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Blood Circulation
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drug effects Dose-Response Relationship, Drug Fibrinolytic Agents / pharmacology*, standards, therapeutic use* Humans Thrombolytic Therapy / standards Tissue Plasminogen Activator / pharmacology*, standards, therapeutic use* Treatment Outcome United States United States Food and Drug Administration Urokinase-Type Plasminogen Activator / pharmacology, standards, therapeutic use Vascular Patency / drug effects |
| Chemical | |
Reg. No./Substance:
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0/Fibrinolytic Agents; 0/tenecteplase; EC 3.4.21.68/Tissue Plasminogen Activator; EC 3.4.21.73/Urokinase-Type Plasminogen Activator |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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