A 72-year-old male presents with acute onset right-sided weakness and aphasia. Symptoms began 2 hours ago. Non-contrast CT head shows no hemorrhage. NIHSS score is 15. BP is 180/100 mmHg. After ensuring airway stability and obtaining IV access, what is the most appropriate next pharmacological intervention?
✓ Correct Answer: Option B
For acute ischemic stroke within 4.5 hours of symptom onset and no contraindications, intravenous alteplase is the standard of care. The patient's blood pressure is within the acceptable range (typically <185/110 mmHg) for alteplase administration.