Thrombolytics/Fibrinolytics & Prothrombotics Flashcards
Thrombolytic Drugs
First Generation
* Urokinase
* Streptokinase
Second Generation
* Alteplase
* Reteplase
* Tenecteplase
MOA of Thrombolytic Drugs
Activates Tissue Plasminogen Activator, activation of plasminogen to plasmin
*Plasmin dissolves clot
Clinical Uses of Thrombolytics
Management:
STEM (St Segment Elevation Myocardial Infarction)
Massive pulmoembolism
Acute ischemic stroke
Central DVT
S/E: Hemorrhage / Bleeding (tx: Tranexamic acid)
From Beta-hemolytic sreptococcus!
Streptokinase
SE: Hypersensitivity (tx: Diphenhydramine IV)
Anisoylated Plasminogen Streptokinase
Activator Complex (APSAC)
Anistreplase
Recombinant tPA
*Alteplase, Reteplase
Non-antigenic
From mammalian kidneys
Urokinase
Used for Acute Coronary Syndromes such as Unstable Angina, Non-STEMI
ASA + Clopidogrel
GP2b / GP3a Blockers
Used for STEMI & Stroke
Thrombolytics
LMWH
ASA
Used for Pulmonary Embolism
Thrombolytics
LMWH
Prothrombotics
Vitamin K1, K2, K3
E-aminocaproic Acid
Aprotinin
Vitamin K
a. Vit K1 (Phytonadione) - clinically useful
b. Vit K2 (Menaquinone) - synthesized by colonic bacteria
c. Vit K3 (Menadione) - water soluble
MOA of Vitamin K
Increases supply of reduced vitamin K, which is required for synthesis of functional vitamin K-dependent clotting and anticlotting factors
Uses of Vitamin K
- Prevention of hemorrhagic disease in newborn
- Treatment of bleeding associated with vit K deficiency (Warfarin Toxicity, wherein Vit K1 is the antidote)
Prevention & treatment of postprocedural
bleeding
E-aminocaproic Acid
Analog: Tranexamic Acid
MOA: Inhibits plasminogen activation
