CV: Fibrinolytic drugs Flashcards
Alteplase should be given within how long of symptom onset?
6-12 hours of symptom onset.
Reteplase and streptokinase should be given within how long of symptom onset?
12 hours.
Tenecteplase should be given within how long of symptom onset?
6 or less
Alteplase, streptokinase and urokinase can be used for other thromboembolic disorders such as what?
DVT and PE
Alteplase is also licensed for use in what condition? (other than DVT, PE and MI)
Acute ischaemic stroke.
Urokinase is also licensed for what? (other than DVT, PE and occlusive periphral disease)
Urokinase is also licensed to restore the patency of occluded intravenous catheters and cannulas blocked with fibrin clots.
Reteplase and tenecteplase are licensed for use in what?
Both only in acute MI
Tissue plasminogen activator (t-PA) converts plasminogen into what?
t-PA converts plasminogen into plasmin, the latter enzyme being heavily responsible for clot breakdown.
Why does the effectiveness of streptokinase decline with subsequent doses?
The presence of antibodies.
Why does streptokinase have a slower onset of action than alteplase (and related compounds)?
Due to the time taken to complex with plasminogen.
What is alteplase commonly administered with heparin?
To reduce the risk of reocclusion due to the short duration of action of alteplase.
Steptokinase is derived from haemolytic streptococci. It is inactive until it binds to what?
Ciruculating plasminogen.
How do the half-lifes of streptokinase, alteplase, reteplase and tenectplase compare?
1h for streptokinase (similar for tenecteplase)
0.5h for alteplase or reteplase.
Other than haemorrhage, what side effects are associated with fibrinolytic drugs?
Hypotension which is dose related and seen more commonly with streptokinase.
Due to its bacterial origin, streptokinase can also cause allergic reactions.
Antiplatelet drugs have action where?
Effective in the arterial circulation.
