Fibrinolytic drugs Flashcards
Fibrinolytic drugs 1 group and 3 drugs
Recombinant tissue plasminogen activators (t-PA)
Urokinase
Streptokinase
Anistreplase
Fibrinolytic drugs - indications
Degrade thrombus in MI, thrombotic stroke, pulmonary embolism.
t-PAs - 3 drugs
Alteplase
Reteplase
Tenecteplase
Fibrinolytic drugs - MOA
Convert plasminogen to plasmin.
Fibrinolytic drugs - adverse effects
Bleeding, but less with t-PAs.
Arrhythmias (tachy and brady) –> from free radicals after reperfusion of coronary arteries after thrombolysis.
Streptokinase - hypersensitivity (anaphylactic shock), should not be used repeatedly in same pt.
Treatment of fibrinolytic drug-associated hemorrhage
Aminocaproic acid - inhibits fibrinolysis.
Aminocaproic acid - indications
Hemorrhage by fibrinolytic drugs.
After GI or prostate surgery.
Cancer pts during radiation/chemo.
Aminocaproic acid - amd
Orally or intravenously
Aminocaproic acid - adverse effects
Thrombosis, hypotension, arrhythmias.
Tranexamic acid - what is it, and MOA.
Antifibrinolytic drug. Occupies the lysine binding sites of plasmin for fibrin.
Tranexamic acid - indications
Heavy menstrual bleedings.
Tansexamic acid - adverse effects
Thrombotic events (esp if pts are on hormonal contraceptives, are obese or smoking).
Fibrinolytic drugs that may be given by infusion
Streptokinase, alteplase
Fibrinolytic drugs that may be given in bolus
Reteplase
Tenecteplase
Systemic fibrinogen depletion of fibrinolytic drugs
Streptokinase: marked
Reteplase: moderate
Alteplase: mild
Tenecteplase: minimal.
