Which of the following plasminogen activator (fibrinolytic) can be given as bolus dose in patients with acute myocardial infarction:
**Core Concept**
The question requires knowledge of fibrinolytic therapy in acute myocardial infarction (AMI). Fibrinolytic agents are used to dissolve blood clots in the coronary arteries, restoring blood flow to the heart muscle. The correct answer is a specific type of plasminogen activator that can be administered as a bolus dose in patients with AMI.
**Why the Correct Answer is Right**
The correct answer is **Alteplase (tPA)**. Alteplase is a recombinant tissue plasminogen activator that works by converting plasminogen to plasmin, which then breaks down fibrin clots. Alteplase can be administered as a bolus dose, followed by a continuous infusion, to rapidly dissolve the blood clot in the coronary artery. This is particularly useful in patients with AMI, as it can restore blood flow to the heart muscle and reduce the size of the infarct.
**Why Each Wrong Option is Incorrect**
**Option A:** **Reteplase** is another recombinant plasminogen activator, but it is administered as a double bolus dose, not a single bolus dose.
**Option B:** **Streptokinase** is a non-recombinant plasminogen activator that is administered as a continuous infusion, not a bolus dose.
**Option D:** **Urokinase** is another non-recombinant plasminogen activator that is administered as a continuous infusion, not a bolus dose.
**Clinical Pearl / High-Yield Fact**
It's essential to note that the choice of fibrinolytic agent and the dosing regimen may vary depending on the specific clinical scenario and the patient's underlying conditions.
**Correct Answer:** C.