Thrombolytics

Question 1

Streptokinase

Answer 1

MoA - Fibrinolytic

I.V.

Ind - Thrombolysis, stroke, MI, pulmonary embolism

Adverse - Bleeding

Question 2

Urokinase

Answer 2

Not used in U.S.

MoA - Fibrinolytic

I.V.

Ind - Thrombolysis, stroke, MI, pulmonary embolism

Adverse - Bleeding

Question 3

Tissue plasminogen activator (t-PA)

Answer 3

MoA - Fibrinolytic

I.V.

Ind - Thrombolysis, stroke, MI, pulmonary embolism

Adverse - Bleeding

Found in the body

Question 4

Alteplase

Answer 4

MoA - Recombinant tissue plasminogen activator

I.V.

Ind - Stroke, ST-elevated MI, pulmonary embolism

Adverse - Bleeding

Question 5

Reteplase

Answer 5

MoA - Mutant tissue plasminogen activator (non-glycosylated)

Longer 1/2 life

I.V.

Ind - Hard to dissolve neurological clots (Fareed), ST-elevated MI

Adverse - Bleeding

Question 6

Tenecteplase

Answer 6

MoA - Mutant tissue plasminogen activator

High fibrin specificity, longer 1/2 life

I.V.

Ind - Hard to dissolve neurological clots (Fareed), ST-elevated MI

Adverse - Bleeding

Question 7

Epsilon aminocaproic acid (AMICAR)

Answer 7

MoA - anti-fibrinolytic

Lysine analogue

I.V.

Ind - Reversal of bleeding

Adverse - Hypotension

Metab - Minimally hepatic (DNTK)

Question 8

Tranexamic acid (AMCHA)

Answer 8

MoA - anti-fibrinolytic

I.V.

Ind - Reversal of bleeding

Adverse - Retinopathy

Question 9

Aprotinin

Answer 9

MoA - anti-fibrinolytic

I.V.

Ind - Reversal of bleeding

Adverse - Graft thrombosis

No longer used

Question 10

Ancrod

Answer 10

MoA - fibrinolytic

Snake venom, not used

I.V.

Ind - Stroke

Adverse - Allergic reaction