THROMBOLYTICS

Question 1

THROMBOLYTICS: (fibrinolytic drugs)

Answer 1

1. alteplase
2. reteplase
3. tenecteplase
4. streptokinase
5. urokinase

Question 2

mechanism of action:

Answer 2

1. alteplase + reteplase + tenecteplase → recombinant t-PA, catalyze conversion of plasminogen → to plasmin, degrades clots
2. streptokinase → from Streptococci → rarely used
3. urokinase → from human neonatal kidney cells, cleave arginine-valine bond of plasminogen → to yield active plasmin

Question 3

indications:

Answer 3

1. lysis of clots in MI, thrombotic stroke, pulmonary embolism
2. 2-6h therapeutic window
3. urokinase → ONLY approved for pulmonary embolism

Question 4

CONTRAindications:

Answer 4

1. PREGNANCY
2. healing wounds
3. history of cerebrovascular accident
4. brain tumor
5. head trauma
6. intracranial bleedings
7. metastatical cancer

Question 5

side effects:

Answer 5

1. hemorrhages (less with t-PA)
2. arrhythmias
3. hypersensitivity → streptokinase