Tissue Plasminogen Activator (tPA)
- tPA is a drug used for treating emergency stroke cases
- Only applied during the first three hours of stroke diagnosis
- tPA is dangerous and is only used when it is completely necessary
- Ohara et al. (2019)
Stroke occurs as an emergency and immediate response is always needed. tPA provides a solution for stroke cases and should only be applied within the first three hours of stroke attack. Generally, Stroke poses other health risks hence it is not recommended at all times
History of tPA
- Discovered in the 1930s
- First trial done on minor cases of Ischemic stroke
- Has been used in the treatment of Stroke since then
- Development done in phases
The tPA drug was discovered in the 1930s. Researchers found that tPA would activate fibrinolytic system, hence potential to treat stroke with was plasmin recognized. The drug has been developed in phases and currently research is in phase III and is trying to check for ways of addressing the negative impacts.
Creating tPA
- tPA is a serine protease
- Prepared in the lab using recombinant biotechnology
- Formed by aggregation of activated platelets into fibrin meshes by activating plasminogen
- Also referred to as recombinant tissue plasminogen activator
Recombinant biotechnology makes it possible to create tPA in the lab. Activated platelets are aggregated into fibrin meshes by activating plasminogen. The tPA prepared in the lab is referred to as recombinant tissue plasminogen activator.
Age and tPA functionality
- Age affects the outcome of tPA application
- Advancing age is associated with an increased comorbidities and worse outcomes
- Patients above 80 years of age at a higher risk of hemorrhages from tPA application
- Recommended for patients less than 60 years old
One of the risk factors for negative impacts of tPA is age. Individuals above 55 years tend to be at a higher risk of adverse tPA reactions. Generally, the risk of hemorrhages grows significantly with advancing age. The rate of negative reactions is significantly low for individuals below 60 years.
Symptoms of Negative Side Effects of tPA
- Nausea
- Vomiting
- Low blood pressure
- Dizziness
- Mild fever
- Allergic reactions
tPA is associated with a series of adverse side effects. First, nausea is a common phenomena for victims. Patients may also vomit and report low blood pressure. Dizziness, mild fever and allergic reactions may also appear as side-effects.
Effects of tPA on the Body
- Causes cerebral bleeding
- Damages the blood-brain barrier
- Leads to uncontrolled bleeding
The adverse effects of using tPA include cerebral bleeding, which may be far dangerous compared to stroke. Also, tPA has been reported to destroy blood-brain barrier, which is responsible for protecting the brain from toxic substances in the rest of the body. Moreover, tPA may interfere with platelet formation leading to uncontrolled bleeding.
Cure for tPA-induced complications
- Use of Gleevec to minimize severe tPA reactions
- Only use tPA three hours after stroke occurs
- Application to follow the procedure shown in the picture
Researchers have been working towards finding solutions to the negative impacts of tPA. One of the proposed solution is the use of Gleevec, which minimizes the rate of bleeding caused by tPA. Also, recommendations are made such that tPA is only applied for the first three hours after stroke occurs.
Impact on Daily Life
- The effect of tPA on platelets causes severe bleeding
- Daily life may involve strenuous activities that may trigger bleeding
- Victims may have challenges undertaking activities that may lead to bleeding
Most daily life activities are strenuous and may lead to bleeding. The impact of tPA on bleeding may mean that individual have to remain cautios to avoid bleeding. Generally, daily activities cannot be carried outcomfortably.
Stroke in the US
- Risk doubles after 55 years of age
- More than 795, 000 people suffer from stroke yearly
- More than 600, 000 cases are new cases
- More than 185, 000 cases are recurrent cases of stroke
- George et al. (2015)
The rate of stroke cases in the US is alarming. Each year, the US witnesses more than 600, 000 new cases of stokes and more than 185, 000 recurrent cases. The need for attention is thus crucial and tPA has been widely used.
References
- Ohara, T., Menon, B. K., Al-Ajlan, F. S., Horn, M., Al Sultan, A. S., Letteri, F., … & Dowlatshahi, D. (2019). Thrombus Migration is a Common Phenomenon With IV TPA and May Have Negative Effects on Outcome When TPA Treatment is Given Before Endovascular Thrombectomy in Proximal Occlusions. Stroke, 50(Suppl_1), A82-A82.
- George, B. P., Asemota, A. O., Dorsey, E. R., Haider, A. H., Smart, B. J., Urrutia, V. C., & Schneider, E. B. (2015). United States trends in thrombolysis for older adults with acute ischemic stroke. Clinical neurology and neurosurgery, 139, 16-23.