Fibrinolytics

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Author:
merazar15
ID:
228616
Filename:
Fibrinolytics
Updated:
2013-07-30 14:07:09
Tags:
Fibrinolytics
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Description:
pharm
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  1. drugs:
    • Fibrin selective "clot specific"
    •    Alteplase
    •    Reteplase
    •    Tenectplase

    • Nonselective
    •    Streptokinase
    •    Urokinase
  2. which is the safest of all of them?
    • Tenecteplase
    • -dose is wt based
    • -more fibrin specific than alteplase
    • -less likely to elicit serious bleeding
  3. MOA:
    • CLOT BUSTERS!!
    • Plasmin is a protease that digests fibrin (a fibrinolytic)
    • These agents are plasminogen activators and cleave plasminogen to form plasmin
    • Alteplase, reteplase, and tenecteplase require fibrin for activity and their fibrinolytic effects will be (mainly) localized to the clot
  4. indications:
    • acute STEMI
    • massive PE
    • thrombotic stroke
    • occluded IV lines 
    •    Must be administered as early as possible after onset of STEMI symptoms ·         Prehospital fibrinolysis or within 30 minutes of hospital arrival
    •    At least within 6 hours of onset (preferred)
    •    Initiate therapy within 3 hours after the onset of stroke symptoms· 
    •    Only after the exclusion of intracranial hemorrhage by CT scan or other diagnostic imaging method
  5. CI:
    SE:
    • any potential source for major bleeding
    • hemorrhage (major concern) and hypersensitivity

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