Table 5. Fibrinolytic Agents
Patency Rate
Fibrinolytic
Agent
Dose
Fibrin
Specificity
Antigenic
(90 min TIMIa
2 or 3 flow)
Fibrin-specific
Tenecteplase
(TNK-tPA)
Single IV weightbased bolusb
Strong
No
85%
Reteplase
(rPA)
10 units + 10 units
IV boluses given
30 min apart
Less strong
No
84%
Alteplase (tPA)
90-min weightbased infusionc
Less strong
No
73%-84%
Yese
60%-68%
Non–fibrin-specific:
Streptokinased
1.5 million units IV
No
given over 30-60 min
a
TIMI, Thrombolysis In Myocardial Infarction
30 mg for weight <60 kg; 35 mg for 60-69 kg; 40 mg for 70-79 kg; 45 mg for 80-89 kg; and 50 mg
for ≥90 kg.
c
Bolus 15 mg, infusion 0.75 mg/kg for 30 min (maximum 50 mg), then 0.5 mg/kg (maximum
35 mg) over the next 60 min. Total dose not to exceed 100 mg.
d
Streptokinase is no longer marketed in the United States but is available in other countries.
e
Streptokinase is highly antigenic and absolutely contraindicated within 6 mo of previous exposure
because of the potential for a serious allergic reaction.
b
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