enoxaparin + alteplase + unfractionated heparin

This is a combination therapy consisting of enoxaparin, alteplase, and unfractionated heparin. - **Enoxaparin** is a low molecular weight heparin (LMWH) anticoagulant that potentiates the activity of antithrombin III, leading to inhibition of factor Xa and thrombin generation[3]. - **Alteplase** is a recombinant tissue plasminogen activator (tPA) that promotes fibrinolysis by converting plasminogen to plasmin, which degrades fibrin clots. - **Unfractionated heparin (UFH)** is an anticoagulant that also enhances antithrombin III activity, inhibiting thrombin and factor Xa[7]. This combination may be used in acute settings such as high-risk pulmonary embolism or ST-elevation myocardial infarction (STEMI), where rapid clot dissolution and prevention of further thrombosis are critical. Clinical protocols may use these agents sequentially or in specific combinations depending on renal function and bleeding risk[1][4][5].