STREPTOKINASE

It is obtained from b haemolytic Streptococci group C. It is inactive as such, forms a complex with circulating plasminogen which then causes limited proteolysis of plasminogen to plasmin. Plasmin acts directly on fibrin breaking it down to achieve thrombolysis.

Indications

Acute myocardial infarction Acute thrombosis of arteries. Pulmonary embolism. Deep venous thrombosis.

Dosage

Acute myocardial infarction: i.v. 750,000-1.5 million i.u. in 1 hr. Intracoronary: 20,000 i.u. stat followed by 2000-4000 i.u./min for 30-90 min. Deep venous & arterial thrombosis. 1.5 million i.u. in 6 hrs.

Contra-Indications

Severe hypertension, cerebral haemorrhage. G.I. bleeding, hepatic or kidney disease. Diabetes mellitus. Acute pancreatitis. Recent haemorrhages. Recent streptococcal infections. Ulcerative colitis.

Special Precautions

Parturition, surgery or invasive procedures within last 10 days. Menstrual bleeding, followup with menstrual bleeding. Subacute bacterial endocarditis.

Side Effects

Hypotension, arrhythmias. Febrile reactions, anaphylaxis, fever, haemorrhage.

Drug Interactions

Aspirin, dipyridamole, heparin & anticoagulants increase risk of haemorrhage