Download Thrombolytic drugs

BY :DR. ISRAA OMAR
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It is initiated concomitantly with coagulation
cascade, resulting in the formation of active
plasmin ,which digest fibrin .
The main drug of this group are streptokinase
and tissue plasminogen activator (tPA),for
example alteplase
The main use is in acute STMI ,acute stroke,
clearing cannula ,arterial thromboembolism
and life threatening DVT and pulmonary
embolism
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Is a non –enzyme protein extracted from culture
of streptococci
It form stable complex with plasminogen and
gains enzymic activity ;then causes fibrinolysis
The major adverse effect is bleeding include GI
Hemorrhage and stroke
Hemorrhage can be treated with traneximic acid
Hypotension and hypersensitivity may also
recorded
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Both are recombinant tissue plasminogen
activators.
Alteplase is a single chain where as duteplase is a
double chain
They preferentially plasminogen that is bound to
fibrin ,they are said to be clot selective .
They dissolve formed thrombus and avoid
systemic activation of plasminogen
They can cause hemorrhage but less than
streptokinase
No hyper sensitivity reaction occur with them
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Active internal bleeding
Bleeding diatheses
Pregnancy
Uncontrolled hypertension
CPR
Recent major surgery or Eye surgery
Recent hemorrhagic stroke
BY:DR ISRAA OMAR
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Both are synthetic agents
Work by inhibition of plasminogen activation
They are orally active
A potential side effect of treatment is
intravascular thrombosis
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It stops bleeding by blocking plasmin
It can inhibit streptokinase
It is used to reduce blood loss in patients
undergoing cardiopulmonary bypass surgery
Side effect include anaphylactic reaction if
there is previous exposure within 12 month ,
renal dysfunction is also reported with the
use of this drug
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Antagonizes the anticoagulant effect of
heparin
It is derived from fish sperm and testes and
has a high content of arginine which make it
basic drug
It is positive charge neutralize the negative
charge of heparin thus making a stable
complex and prevent the action of heparin
Side effect include dyspnea , flushing ,
hypotension and bradycardia especially when
injected rapidly
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It antagonize the action of oral anticoagulant
The action of vitamin k start after 24 hours;
thus ,if immediate action is required ,fresh
frozen plasma should be infused
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