Tissue plasminogen activator (tPA) is a medication that doctors administer following a stroke caused by a blood clot. It breaks up the blood clot to allow blood flow to return to the brain.
An ischemic stroke occurs when a blood clot prevents blood flow to the brain. This can lead to tissue death, brain damage, disability, and death.
A doctor can administer tPA to restore the blood flow to the brain, which can help to
When the blood clumps, a protein called fibrin forms meshes in the blood clot. To break up a blood clot, tPA activates the enzyme called plasminogen and converts it into plasmin. Plasmin dissolves the links between fibrin molecules in the blood clot to break it up.
This article will examine who is eligible to receive tPA and how doctors administer it. It also looks at the potential side effects and a person’s outlook after receiving it.
Doctors perform treatment for ischemic stroke by removal of the clot. Doctors can accomplish this by use of the medication Alteplase. This medication also helps to dissolve unwanted blood clotting.
If possible, a doctor should administer tPA within
Before administering the medication, the doctor will rule out intracranial hemorrhage as the cause of the stroke.
Initially, medical staff will administer 10% of the total dose as a bolus in the first minute. They will then administer the remaining dose over the next hour. The total dose should not exceed 90 mg.
Medical staff will monitor blood pressure and watch for side effects.
Doctors will carefully evaluate the best time and circumstances to administer tPA to have the best opportunity to break up a blood clot.
The inclusion criteria are as follows:
- an ischemic stroke diagnosis
- it has been within 4.5 hours of the stroke
A person may not be able to receive tPA if:
- there is current intracranial hemorrhage
- there is subarachnoid hemorrhage
- there is active internal bleeding
- a person has undergone intracranial or intraspinal surgery within 3 months
- a person has experienced serious head trauma within 3 months
- a person is experiencing severe and uncontrolled high blood pressure, or hypertension
- a person has an increased susceptibility to bleeding or bruising
A doctor may not administer tPA between 3 and 4.5 hours if:
- the person is age 80 or over
- the stroke is severe and has a National Institute of Health Stroke Scale of over 25
- the person has a history of diabetes or prior stroke
- the person is taking oral anticoagulant medication
Side effects occur in
The most common side effect is bleeding. Because tPA breaks the bonds between platelets, it can potentially cause bleeding problems. A doctor will carefully evaluate those risks before treatment.
Bleeding issues could include:
- intracranial bleeding
- retroperitoneal bleeding
- gastrointestinal bleeding
- genitourinary bleeding
- respiratory bleeding
- superficial or surface bleeding
- gingival bleeding
There is always the
Other side effects include:
- pulmonary edema
- arterial embolism
- orolingual angioedema
- intracranial hemorrhage
- deep vein thrombosis
When used quickly to treat ischemic stroke, the outcome of tPA treatment is fair to good, according to literature from
There are no recorded long-term effects of this drug.
A tPA is a drug that helps to treat an ischemic stroke. It breaks down the blood clot, restoring the flow of blood to the parts of the brain affected by the stroke.
Blood clots happen when platelets clump together into fibrin meshes. The drug converts the glycoprotein plasminogen to plasmin. Plasmin breaks down the bonds of blood clots and dissolves them.
A doctor must administer tPA quickly, within the first 3 hours following the onset of symptoms if possible.
Several conditions mean that a person may not be eligible for tPA, including recent head bleeding or trauma, some surgeries, a bleeding disorder, or uncontrolled hypertension.