STREPTOKINASE

1) Action

• Fibrinolytic; plasminogen activator

2) Mechanism

• Fibrinolytic drugs rapidly lyse thrombi by formation of the protease plasmin

• Create a general lytic state when administered IV

• Both protective haemostatic thrombi and target thromboemboli are broken down

3) Indications

• Pulmonary emboli

• Central DVT

• Acute coronary thrombosis

4) Effects on organs—side effects

• Both protective haemostatic thrombi and target thromboemboli are broken down

5) Toxic effects/ precautions with administration

• As streptokinase is a protein derived from streptococci, patients with antistreptococcal AB may have an allergic reaction and therapeutic resistance

• Haemorrhage

6) Contraindications

• Absolute: active internal bleeding, cerebrovascular disease

• Relative: Surgery within 2 weeks, pregnancy, menstruation, recent trauma, recent CPR, infective endocarditis, GU, severe hypertension, lumbar puncture, coagulopathy

7) Reversal, antagonism or antidote

• Stop infusion, FFP, Amicar or trasylol

8) Loading dose, maintenance dose, frequency & method of administration

• Administered by a loading dose IV followed by a maintenance dose usually for 24 hours

9) Drug’s metabolism—Drug’s excretion—Half life (pharmacokinetics)

• Half life 15 minutes