Drug information of Streptokinase
Streptokinase is used to dissolve blood clots that have formed in the blood vessels. It is used immediately after symptoms of a heart attack occur to improve patient survival.
streptokinase may also be used to treat blood clots in the lungs (pulmonary embolism) and in the legs (deep venous thrombosis) Streptokinase is also used to dissolve blood clots in tubes (catheters) that are inserted in blood vessels
Mechanism of effect
Converts plasminogen to the enzyme plasmin, which aids in dissolution of blood clots
Streptokinase creates an active complex which promotes the cleavage of the Arg/Val bond in plasminogen to form the proteolytic enzyme plasmin. Plasmin in turn degrades the fibrin matrix of the thrombus, thereby exerting its thrombolytic action. This helps eliminate blood clots or arterial blockages that cause myocardial infarction.
No metabolites identified. Streptokinase is cleared by the liver. The t ½ is approximately 23 min (for activator complex).
Drug indicationsAcute Deep Vein Thrombosis , acute MI , pulmonary embolism , acute arterial thrombi and embolism , arteriovenous cannulae
Acute Evolving Transmural MI Adults :
IV infusion Administer as soon as possible after symptom onset (greatest benefit when administered within 4 h, but benefit has been reported up to 24 h).
Infuse a total dose of 1,500,000 units within 60 min.
Intracoronary infusion Administer 20,000 units by bolus followed by 2000 units/min for 60 min (total dose, 140,000 units).
Drug contraindicationsUncontrolled hypertension , active pathological bleeding , history of cerebrovascular accident , recent surgery or trauma
Side effectsnausea , vomiting , allergic reaction , hypotension , fever , back pain , bronchospasm , hemorrhage , Anaphylactic reaction
InteractionsIbuprofen , Indomethacin , Dipyridamole , Dipyridamol+aspirin , Celexib , Phenindione , Desirudin , Tositumomab , Ibritumomab tiuxetan , Betrixaban , Ramucirumab , Aprotinin , Dasatinib , cangrelor , defibrotide
1-Use with caution in patients with recent (within 10 days) major surgery, obstetrical delivery, organ biopsy, previous puncture of noncompressible vessels; recent (within 10 days) serious GI bleeding, recent (within 10 days) trauma including cardiopulmonary resuscitation, hypertension (systolic BP greater than 180 mm Hg or diastolic BP greater than 110 mm Hg), high likelihood of left heart thrombus (eg, mitral stenosis with atrial fibrillation), subacute bacterial endocarditis, hemostatic defects including those secondary to severe hepatic or renal disease, cerebrovascular disease, diabetic hemorrhagic retinopathy, septic thrombophlebitis, occluded AV cannula at seriously infected site, or any condition in which bleeding constitutes a significant hazard or would be particularly difficult to manage because of location; use with caution in patients who are pregnant or older than 75 yr of age.
2-Rapid lysis of coronary thrombi has been shown to cause reperfusion arterial or ventricular dysrhythmias, requiring immediate treatment. 3-Major and minor bleeding may occur. Severe, sometimes fatal, internal bleeding involving GI, hepatic, GU, or intracerebral sites has occurred.
4-Serious and fatal cholesterol embolism may occur. 5-Because of increased likelihood of resistance caused by antistreptokinase antibodies, streptokinase may not be effective if administered within 5 days to 12 mo of prior streptokinase or anistreplase administration, or streptococcal infections (eg, streptococcal pharyngitis).
Points of recommendation
• Advise patient, family, or caregiver that medication will be prepared and administered by a healthcare professional in a medical setting. • Instruct patient, family member, or caregiver to report any signs of bleeding or allergic reaction immediately.