Updated: 8/17/2016

Thrombolytics

0%
Topic
Review Topic
0
0
N/A
N/A
Questions
1 1
0
0
0%
0%
Evidence
3 3
0
0
Overview
  • Thrombolytics catalyze the formation of endogenous plasmin from plasminogen precursor
    • plasmin is a serine protease that degrades clots (thrombi)
  • Drugs
    • tPA (alteplase)
    • streptokinase
    • urokinase
    • APSAC (anistreplase)
  • Mechanism
    • catalyze conversion of plasminogen to plasmin
      • cleaves fibrin clots
      • cleaves thrombin
    • clot-specificity
      • tPA is clot-specific
        • acts only on fibrin-bound plasminogen
      • streptokinase is not clot specific
        • depletes circulating plasminogen, factor V, factor VIII
    • ↑ PT, ↑ PTT, no change in platelet count
  • Clinical use
    • administer as early as possible following
      • ischemic stroke (tPA)
      • MI
      • DVT
      • pulmonary embolism
  • Toxicity
    • bleeding and intracerebral hemorrhage
      • contraindicated in patients with history of bleeding, surgery, hypertension
    • streptokinase may cause hypersensitivity
      • derived from β-hemolytic streptococci
  • Antagonist
    • aminocaproic acid and tranexamic acid 
      • inhibitor of fibrinolysis
 

Please rate topic.

Average 4.8 of 4 Ratings

Questions (1)
Question locked
Sorry, this question is for
PEAK Premium Subscribers only
Upgrade to PEAK
Evidence (3)
Topic COMMENTS (10)
Private Note