Drug Interactions of Recombinant Tissue Plasminogen Activators
(rtPA):
More Presentations from Naina Mohamed, PhD
© Tissue Plasminogen Activator (tPA) is an enzyme found in blood and
tissues.
© The
major physiological function of Tissue
Plasminogen Activator (tPA) is to generate plasmin which can
dissolve blood clots inside the blood vessels.
© Tissue Plasminogen Activator (tPA) is synthesized mainly in vascular endothelial cells
and is secreted into the plasma continuously.
© Recombinant
tissue plasminogen activators (rtPA) include Alteplase, Reteplase and Tenecteplase.
• The risk of Orolingual angioedema might be increased by the
concomitant use of Alteplase and ACE inhibitors (Captopril,
Lisinopril, Perindopril, etc).
• Concurrent use of Alteplase
and Nitroglycerin (GTN) results in Less coronary artery reperfusion,
Longer time to reperfusion, and more coronary artery Reocclusion
• It is Contraindicated to use Fibrinolytics and Defibrotide concomitantly.
• Drugs increasing the risk of Fibrinolytics
associated Bleeding include…
o
Anticoagulants (Warfarin,
Heparin, Enoxaparin, Dabigatran, etc)
o
Antiplatelet agents
(Aspirin, Clopidogrel, etc)
o Pentosan
Polysulfate Sodium
• Herbs increasing the risk of Fibrinolytics
associated Bleeding include…
o
Fenugreek
o
Garlic
o
Ginkgo
o
Evening Primrose Oil
o
Clove Oil
o
Anise
o
Turmeric (Curcumin)
o
Licorice
o
Asafetida
o
Capsicum (Capsaicin)
o
Celery
o
Kava
o
Cat's claw
o
Medowsweet
o
Feverfew
o
Tan-shen
© Drug interactions can result in significant morbidity and mortality
and thus minimizing the risk for drug interactions should be a goal in drug
therapy.
© The risk of adverse effects could be reduced by healthcare
professionals through the screening, education, and follow up on suspected drug
interactions.
© Pharmacists can play a crucial role in identifying possible drug
interactions by asking patients on Anticoagulants about their herbal and other
alternative medicine product use.
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