Thrombolytics Flashcards
MOA in general of thrombolytic agents?
catalyze the formation of endogenous fibrinolytic plasmin (a serine protease) from it precursor plasminogen
Name some thrombolytic agents.
alteplase or tissue plasminogen activator (tPA), (recombinant)
streptokinase
Streptokinase MOA specifically.
Acts on both bound and free plasminogen (not clot specific) depleting circulating plasminogen and factors V and VIII
acts with plasminogen to produce an “activator complex” that converts plasminogen to the proteolytic enzyme plasmin
Where is streptokinase derived from?
foreign protein derived from B-hemolytic streptococci
When may you not want to use streptokinase as a thrombolytic agent in a patient?
it is antigenic and may cause a problem if a person has had a recent past use or infection - strep ab may decrease activity
MOA of alteplase. Why are there fewer allergic reactions with this drug than streptokinase?
Is clot specific acting mainly on fibrin-bound plasminogen, the natural activator, so few allergy problems
There is a decrease in mortality post MI if you use thrombolytics within what time frame?
within 3 hours
S/E streptokinase?
HSR
What is the antidote for thrombolytic agents?
aminocaproic and tranexamic acids