Thrombolytic Therapy Guidelines for Acute ST-Segment Elevation Myocardial Infarction

For patients diagnosed with acute ST-segment elevation myocardial infarction (STEMI), thrombolytic therapy can be administered using one of three primary regimens. When utilizing urokinase, it is recommended to administer between 1.5 to 2 million international units via intravenous infusion within a 30-minute window. Alternatively, streptokinase may be used at a dosage of 1.5 million units, to be infused intravenously over a 60-minute period.

Preferred Thrombolytic Agents in Clinical Practice

In contemporary clinical settings, recombinant tissue plasminogen activators (rtPAs) are the preferred agents for thrombolytic therapy. These include well-known drugs such as alteplase and tenecteplase. Although their administration protocols are more complex, they offer enhanced efficacy and safety profiles.

Recommended Administration Protocol for rtPA

For alteplase, the recommended administration schedule spans 90 minutes with a total dose of 100 mg. The protocol begins with an initial intravenous bolus of 15 mg, followed by a 30-minute infusion of 50 mg. This is then followed by a 60-minute infusion of the remaining 35 mg. This staged delivery helps optimize therapeutic outcomes while minimizing the risk of complications.