Thrombolytic agent

description on thrombolytic agents

1. THROMBOLYTIC AGENT

2. Thrombolytic agent is a treatment to dissolve dangerous clots in blood vessels, improve blood flow, and prevent damage to tissues and organs. The thrombolytic agents available today are serine proteases that work by converting plasminogens to the natural fibrinolytic agent plasmin . Plasmin lyses clot by breaking down the fibrinogen and fibrin contained in a clot. INTORDUCTION

3. Fibrinolytic agents are divided into 2 categories: fibrin- specific agents Non- fibrin- specific agents CATEGORIES

4. Fibrin- specific agents: include alteplase ( tPA ), reteplase (recombinant plasminogen activator [r-PA], and tenecteplase produce limited plasminogen conversion in the absence of fibrin. Non-fibrin specific agents: eg : streptokinase catalyze systemic fibrinolysis .

5. The most commonly used clot-busting drugs also known as thrombolytic agents include: Eminase ( anistreplase ) Retavase ( reteplase ) Sreptase (streptokinase) T-PA TNKase abbokinase TYPES OF THROMBOLYTIC AGENTS

6. Severe high blood pressure Active bleeding or severe blood loss hemorrhagic stoke from bleeding in the brain. Severe kidney disease Recent surgery Bruising or bleeding at the access site Damage to the blood vessel Migration of the blood clot to another part of vascular system. Kidney damage in pts with diabetes. RISKS OF THROMBOLYTIC AGENTS

7. Streptokinase: ST elevation myocardial infarction Arterial thrombosis DVT Pulmonary embolism Intra- arterial or intravenous catheter occlusion INDICATIONS

8. T-PA Acute myocardial infarction Acute cerebrovascular thrombosis Pulmonary embolism Central venous catheter occlusions

9. Non- cardiogenic pulmonary edema Hypotension Fever and shivering History of cerebrovascular hemorrahage marked hypertension (SAP> 180mm of hg/ DAP> 110 mm of hg) Suspicion of aortic dissection Active internal bleeding ADVERSE EFFECTS

10. History of chronic, severe, poorly controlled hypertension. History of prior ischemic stroke Dementia Recent internal bleeding No compressible vascular punctures Pregnancy Current use of an anticoagulant ( warfarin ) CONTRAINDICATIONS