Which thrombolytic medication is provided as a tissue plasminogen activator?

• A. Heparin
• B. Clopidogrel
• C. Alteplase
• D. Warfarin

Answer: (C)

Thrombolytics that are tissue plasminogen activators dissolve clots by converting plasminogen to plasmin, which then breaks down fibrin. Alteplase is the recombinant tissue plasminogen activator used clinically to promote clot breakdown. It targets plasminogen that’s bound in the clot, making it effective at dissolving thrombi. In contrast, heparin and warfarin are anticoagulants that prevent clot formation (not clot dissolution): heparin enhances antithrombin III to inhibit thrombin and factor Xa, while warfarin inhibits vitamin K–dependent clotting factor synthesis. Clopidogrel is an antiplatelet that blocks platelet aggregation by inhibiting the P2Y12 receptor, and does not dissolve existing clots. So the drug provided as a tissue plasminogen activator is alteplase.