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Thrombolytics work by promoting the conversion of plasminogen to plasmin, an enzyme that dissolves fibrin clots, thereby reopening occluded blood vessels and preventing tissue necrosis. Key indications include acute stroke, myocardial infarction, pulmonary emboli, deep vein thrombosis (DVT), and suspected occlusions in central venous catheters. The document emphasizes the critical timeframe for administration, typically within 4-6 hours post-thrombus formation, and outlines a rigorous monitoring protocol for bleeding complications. This involves assessing patients for bleeding every 15 minutes during the first hour, every 15-30 minutes for the subsequent 8 hours, and at least every 4 hours thereafter. Continuous monitoring of vital signs is also recommended. Laboratory considerations include monitoring activated partial thromboplastin time (aPTT) and hematocrit. The document lists contraindications such as active bleeding, history of stroke or aneurysm, and recent intracranial surgery. Importantly, it highlights the increased risk of bleeding when thrombolytics are co-administered with antithrombotic agents like aspirin, dipyridamole, or anticoagulants. The generic name Alteplase is also mentioned. 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