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Pathway Description
Tenecteplase Action Pathway (new)
Homo sapiens
Drug Action Pathway
Tenecteplase is a plasminogen activator, a modified form of recombinant human tissue, also known as Metalyse and Tnkase, used in emergencies such as myocardial infarction and pulmonary emboli. It is administered intravenously and travels through the bloodstream to target blood clots by activating plasminogen. Tenecteplase acts on plasminogen by cleaving an arginine-valine bond and converting it to its active form of plasmin. Plasmin then acts on the blood clot fibrin mesh and degrades it into degradation products eliminating the blood clot. Due to its anticoagulant and antiplatelet activity herbs and supplements with similar activity should be avoided such as garlic, ginger, bilberry, danshen, piracetam and ginkgo biloba.
References
Tenecteplase Pathway (new) References
Warach SJ, Dula AN, Milling TJ Jr: Tenecteplase Thrombolysis for Acute Ischemic Stroke. Stroke. 2020 Nov;51(11):3440-3451. doi: 10.1161/STROKEAHA.120.029749. Epub 2020 Oct 13.
Pubmed: 33045929
Menon BK, Buck BH, Singh N, Deschaintre Y, Almekhlafi MA, Coutts SB, Thirunavukkarasu S, Khosravani H, Appireddy R, Moreau F, Gubitz G, Tkach A, Catanese L, Dowlatshahi D, Medvedev G, Mandzia J, Pikula A, Shankar J, Williams H, Field TS, Manosalva A, Siddiqui M, Zafar A, Imoukhuede O, Hunter G, Demchuk AM, Mishra S, Gioia LC, Jalini S, Cayer C, Phillips S, Elamin E, Shoamanesh A, Subramaniam S, Kate M, Jacquin G, Camden MC, Benali F, Alhabli I, Bala F, Horn M, Stotts G, Hill MD, Gladstone DJ, Poppe A, Sehgal A, Zhang Q, Lethebe BC, Doram C, Ademola A, Shamy M, Kenney C, Sajobi TT, Swartz RH: Intravenous tenecteplase compared with alteplase for acute ischaemic stroke in Canada (AcT): a pragmatic, multicentre, open-label, registry-linked, randomised, controlled, non-inferiority trial. Lancet. 2022 Jul 16;400(10347):161-169. doi: 10.1016/S0140-6736(22)01054-6. Epub 2022 Jun 29.
Pubmed: 35779553
Hailu K, Cannon C, Hayes S: Tenecteplase use in the management of acute ischemic stroke: Literature review and clinical considerations. Am J Health Syst Pharm. 2022 Jun 7;79(12):944-949. doi: 10.1093/ajhp/zxac010.
Pubmed: 35020806
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