Pharmacology of Thrombolytic Agents

Question 1

Plasmin activators

Answer 1

tPA
Urokinase
Streptokinase
FXIIa

Question 2

Plasmin Inhibitors

Answer 2

PAI-1
TAFI
a2-antiplasmin
a2-Macroglobulin

Question 3

Plasmin

Answer 3

Active from plasminogen
Cleaves fibrinogen and fibrin
Produces fibrinogen degredation products and/or D-dimers

Question 4

Factors That Promote Fibrinolysis

Answer 4

Fibrinogen incorporation into thrombus via fibrin binding
Local release of tPA by endothelial cells
Binding of tPA to fibrin

Question 5

Factors That Inhibit Fibrinolysis

Answer 5

Fibrin crosslinking by FXIIIa

Binding of a2-antiplasmin to fibrin

Question 6

Thrombolytic Therapy

Answer 6

Degradation of clots
Comprised mainly of plasminogen activators
Result in reduction in thrombus size, reduction of fibrinogen levels, and increase in fibrinogen and fibrin degradation products

Question 7

Clinical benefit of Thrombolytic Therapy

Answer 7

Thrombolysis

Degradation of fibrin in the thrombus

Question 8

Side effect of Thrombolytic Therapy

Answer 8

Systemic lytic state

Degradation of plasma fibrinogen by circulating plasmin

Question 9

Complication of Thrombolytic Therapy

Answer 9

Bleeding
Degradation of fibrin in hemostatic plugs
Adversely influenced by prolonged duration of treatment