A patient with acute STEMI presents to a peripheral hospital without PCI capability within 120 minutes. Fibrinolysis is chosen. Which fibrinolytic agent is administered as a single weight-adjusted bolus?

• A Streptokinase
• B Alteplase
• C Urokinase
• D Tenecteplase ✓

Explanation

Tenecteplase is a genetically engineered variant of alteplase with higher fibrin specificity, longer half-life, and resistance to plasminogen activator inhibitor-1, allowing a single weight-based bolus. Alteplase and urokinase require prolonged infusion, and streptokinase is given as a one-hour infusion and is antigenic, causing hypotension and allergic reactions. Tenecteplase is therefore preferred when fibrinolysis is the chosen strategy.

Reference: Katzung's Basic and Clinical Pharmacology, 16th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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