Antifibrinolytics + Thrombolytics

Question 1

What is Tranexamic acid?

Answer 1

Antifibrinolytic

Question 2

What is the MOA of tranexamic acid?

Answer 2

It is a lysine analogue that is able to act as the lysine analogue in plasminogen

Binds to lysine binding site of plasminogen > preventing the binding of the tPA+plasminogen complex from binding to fibrin > inhibiting clot breakdown

Question 3

Tranexamic acid ADRs

Answer 3

Nausea, vomiting, hypotension, thrombosis, transient disturbances of colour vision, allergic skin reaction

Question 4

How do thrombolytics work?

Answer 4

Convert plasminogen to plasmin > plasmin catalyses breakdown of fibrin

Question 5

What is streptokinase?

Answer 5

Thrombolytic protein derived from beta-haemolytic streptococci

Ineffective if given 5 days ad 12 months or more after previous treatment

Question 6

List the relevant thrombolytics

Answer 6

Streptokinase, Urokinase, alteplase, reteplase, tenecteplase

Question 7

What are the recombinant tPA thrombolytics?

Answer 7

alteplase, reteplase, tenecteplase

Question 8

What is the MOA of the recombinant tPA thrombolytics?

Answer 8

convert plasminogen to plasmin > cause fibrnolysis

Greater affinity for plasminogen associated with thrombin compared to circulating plasminogen

Question 9

List some ADRs of thrombolytics

Answer 9

bleeding, transient hypotension (bleeding, allergy)

allergic reactions = fever, chills, anaphylaxis, nausea, bronchospams

Vasculitis, nephritis

Question 10

MOA of urokinase

Answer 10

Serine protease

Cleaves plasminogen to form the active fibrinolytic protease, plasmin