Fibrinolytics

Question 1

Name Fibrinolytics

Answer 1

1) tissue plasminogen activator (tPA)

• Alt /eplase,
• ​ Ret /eplase
• ​ Tenect /eplase
  (“Toy Pl_A_yset”)

​2) Streptokinase​-synthesized by streptococci
(“Strepto-kinectors”)
(“Purple sphere chain”)

Question 2

Fibrinolytics MOA

Answer 2

-plasminogen is converted to plasmin by tPA and streptokinase →plasmin degrades fibrin clots→D-Dimer is a fibrin degradation product formed from clot lysis

(“tPA girl holding plasma general and activated him , then he starts to shoot green shit on fibrin clot and D-shaped branches fly away “)

-

Question 3

which lab values will be increased following a fibrinolytics therpay ?

Answer 3

-PT (prothrombin time , extrinsic)
(“kid holding para trooper”)

-aPTT (activated partial thromboplastin time, intrinsinc)
(“kid holding shooting trooper and making the sound PTTTT”)

Question 4

Fibrinolytics treatment is used for …

Answer 4

-IV fibrinolytics may be used in the setting of ischemic stroke (“Black paint stroke”)

• Administer IV fibrinolytics within 3-4.5 hours of ischemic stroke symptoms
  (“After school painting session 3:00-4:30”)

-IV fibrinolytics can be used for acute treatment of severe DVT and PE
(“Birds nest on ischemic branch”)

-fibronolytics may be used in the acute management of MI
(“Broken heart strings”)

• percutaneous coronary intervention is the preferred reperfusion option in ACUTE STEMI
  (“Corked Bat”)

Question 5

when is Fibrinolytics therapy contraindicated ?

Answer 5

-perform PCI ideally within 2 hours of acute STEMI
(“far far player calling for two”)

-Recent head trauma is a contraindication for fibrinolytic therapy
(“Traumatic plasma beam”)

-recent intracranial surgery is a contraindication for fibrinolytic therapy
(“Red palette knife”)

-White area on CT indicates cerebral hemorrhage – a contraindication for fibrinolytic therapy
(“white area on brain ct”)

-severe hypertension is a contraindication for fibrinolytic therapy
(“High pressure paint tube”)

Question 6

side effects of fibrinolytic therapy

Answer 6

-hemorrhagic stroke
(“Red pain stroke on painting”)

-Streptokinase only can cause allergic reaction and even anaphylaxis
(“strepto-kid choking on streptokinetctors”-choking hazard)

Question 7

what can be used to reverse fibrinolysis?

Answer 7

Aminocaproic acid

• aminocaproic acid competitively inhibits plasminogen activation
  (“Plasma general tucked under mom’s arm”)

Transexamic acid
(“mom holding Exams”)

• ​can be used to reverse tPA

(“Cap on paint tube”)

Question 8

what can reverse coagulopathies?

Answer 8

FFP -Fresh Frozen Plasma
(“yellow kid holding FFP Pilot”)

Cryoprecipitate
(“Cryo ice pack”)