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Antocoagulants work via different mechanisms, thrombolytic, antiplatelet or plasminogen activator r-hirudin and drotrecogin are both direct thrombin inhibitors. Tissue plasminogen activator (tPA) is involved in the breakdown of blood clots. All products are produced by recombinant technology nowadays.

Two historical anticoagulants are introduced: r-hirudin, derived from yeast cells and indicated for heparin induced thrombocytopenia (HIT). Drotrecogin, a r-activated protein C indicated for sepsis (withdrawn 2011) Three TPAs used today are Alteplase, Reteplase, and Tenecteplase, of which Tenecteplase is a prolonged release formulation. All of them are indicated for rescue from myocardial infarction or ischemic attack.

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Pharmacotherapy: Understanding Biotechnology Products

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