THROMBOLYTIC AGENTS

Fibrinolytic agents rapidly lyse thrombi by catalyzing the formation of plasmin from plasminogen. All thrombolytic agents currently in use act directly or indirectly as plasminogen activators. The presently used plasminogen activators are:

1. Streptokinase- a protein synthesized by streptococci, combines with plasminogen to convert it to active plasmin.
2. Urokinase-human enzyme synthesized by the kidneys that directly converts plasminogne to active plasmin
3. Anistreptase (Acylated plasminongen -streptokinase activator)- bacterial streptokinase plus human plasminogen
4. Tissue plaminogen activator (tPA)-this activates preferentially plasminogen that is bound to fibrin.

Indications:

Multiple pulmonary emboli, central deep vein thrombosis and acute myocardial infarction.

Adverse Reactions:

Bleeding and allergic reactions are most common adverse effects thrombolytics.

Contra-indications:

Severe hypertension, recent cranial trauma and history of cerebrovascualr accident.