Thrombolytics

Question 1

MOA in general of thrombolytic agents?

Answer 1

catalyze the formation of endogenous fibrinolytic plasmin (a serine protease) from it precursor plasminogen

Question 2

Name some thrombolytic agents.

Answer 2

alteplase or tissue plasminogen activator (tPA), (recombinant)
streptokinase

Question 3

Streptokinase MOA specifically.

Answer 3

Acts on both bound and free plasminogen (not clot specific) depleting circulating plasminogen and factors V and VIII

acts with plasminogen to produce an “activator complex” that converts plasminogen to the proteolytic enzyme plasmin

Question 4

Where is streptokinase derived from?

Answer 4

foreign protein derived from B-hemolytic streptococci

Question 5

When may you not want to use streptokinase as a thrombolytic agent in a patient?

Answer 5

it is antigenic and may cause a problem if a person has had a recent past use or infection - strep ab may decrease activity

Question 6

MOA of alteplase. Why are there fewer allergic reactions with this drug than streptokinase?

Answer 6

Is clot specific acting mainly on fibrin-bound plasminogen, the natural activator, so few allergy problems

Question 7

There is a decrease in mortality post MI if you use thrombolytics within what time frame?

Answer 7

within 3 hours

Question 8

S/E streptokinase?

Answer 8

HSR

Question 9

What is the antidote for thrombolytic agents?

Answer 9

aminocaproic and tranexamic acids