Tenecteplase differs from alteplase in several pharmacological properties that make it suitable for single-bolus administration in STEMI. Which combination is correct for tenecteplase compared with alteplase?

• A Lower fibrin specificity and longer plasma half-life
• B Higher fibrin specificity but shorter half-life requiring continuous infusion
• C Identical half-life but greater antigenicity
• D Higher fibrin specificity, greater resistance to PAI-1, and longer half-life allowing bolus dosing ✓

Explanation

Tenecteplase is a genetically engineered alteplase variant with amino acid substitutions that confer higher fibrin selectivity, slower clearance (half-life about 20 to 24 minutes versus 4 to 6 minutes for alteplase), and increased resistance to plasminogen activator inhibitor 1. These properties permit weight-adjusted single bolus administration, unlike alteplase which needs an accelerated infusion. It remains non-antigenic like alteplase.

Reference: Katzung Basic and Clinical Pharmacology, 15th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.