ALS MEDICATION

Fibrolytic Drugs

  • Streptokinase
  • Urokinase
  • tPA (Tissue plasminogen activator)
    1. Therapeutic Effects
      1. Acts to break down fibrin portion of previously formed clots.

    2. Indications
      1. Acute myocardial infarction.
      2. Acute pulmonary embolism.
      3. Deep venous thrombosis.
      4. Peripheral artery thrombosis.
      5. Arteriovenous shunt occlusion.

    3. Contraindications/Precautions
      1. Absolute.

        1. Active bleeding.
        2. CVA or intracranial/spinal surgery within 2 months.
        3. Intracranial neoplasm.

      1. Relative.

        1. Major surgery/biopsy within 10 days.
        2. GI bleeding or biopsy within 10 days
        3. Recent trauma.
        4. Recent CPR.
        5. Pregnancy or post partum.
        6. Uncontrolled hypertension.
        7. Severe hepatic or renal disease.
        8. Active malignancy.

    4. Side Effects
      1. Allergic reaction (greatest with Streptokinase).
      2. Reperfusion dysrhythmias
      3. Bleeding (minor to severe).

    5. Administration and Dosage
        Drug
        Loading
        infusion
        Streptokinase
        20K-750K IU
        100-1,000K IU/hour
        Urokinase
        4,400 IU
        4,400 IU/hour
        tPA
        90-100mg
        10-25mg/hour
        NOTE:
        Doses change constantly and this table is a guide to some of the ranges that may be encountered.

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