Which fibrinolytic agent selectively activate fibrin bound plasminogen rather than circulating plasminogen: (A) Streptokinase, (B) Urokinase, (C) Alteplase, (D) Both 'A' and 'C'
Answer is C. FIBRINOLYTICS (Thrombolytics) Alteplase It is moderately specific for fibrin bound plasminogen, so that circulating fibrinogen is lowered only by ~ 50%. It is rapidly cleared by liver and inactivated by plasminogen activator inhibitor-1 (PAI-1). The plasma t 1/2 is 4-8 min. Because of the sho t 1/2 , it needs to be given by slow i.v. infusion and often requires heparin co-administration. It is nonantigenic, but nausea, mild hypotension and fever. Ref:- kd tripathi; pg num:-627