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fibrinolytic agent (thrombolytic agent)
Indications:
- thrombolytic therapy
- chest pain > 30 min & < 6 hours unrelieved by nitroglycerin & associated with at least 1 mm ST elevation in 2 contiguous leads with reciprocal ST segment depression
- massive pulmonary embolism with sysolic blood pressure < 90 mm Hg, or evidence of poor tissue perfusion despite adequate resuscitation
Contraindications:
1) major surgery or trauma within 10 days.
2) history of CNS hemorrhage, tumor, aneurysm or AVM.
3) hemorrhagic CVA within 6 months.
4) coma
5) bleeding diathesis
6) prolonged CPR (> 10 min).
7) pregnancy
8) GI bleed within 3 months.
9) severe, uncontrolled hypertension (> 200/110).
10) prior streptokinase with 1 year (streptokinase only).
Related
antithrombotic agent
Specific
Abbokinase (urokinase)
anistreplase (APSAC, Eminase)
heparin
nattokinase
plasmin; fibrinolysin
plasminogen; contains: plasmin heavy chain A; activation peptide; angiostatin; plasmin light chain B (PLG)
recombinant tissue plasminogen activator (TPA, t-PA, rt-PA,)
streptokinase (Streptase, Kabikinase, Streptozyme)
tranexamic acid (Cyklokapron, Lysteda)
urokinase; urokinase-type plasminogen activator; U-plasminogen activator; uPA (PLAU)
General
cardiovascular agent
hematologic agent
References
- The Pharmacological Basis of Therapeutics, 9th ed.
Gilman et al, eds. Permagon Press/McGraw Hill, 1996
- Kahn SR, de Wit K.
Pulmonary Embolism.
N Engl J Med. 2022 Jul 7;387(1):45-57.
PMID: 35793208 Review.