Fibrinolytics Flashcards
What are examples of fibrinolytic agents?
Anistreplase, Alteplase, Reteplase, Steptokinase, Urokinase
When is the Fibrinolytic system activated?
When homeostasis has been restored, blood loss has been prevented and degradation of fibrin.
What is plasmin formed by?
Plasminogen (Proenzyme)
-Has affinity for fibrin, must be activated
-tissue plasmin activators (tPA)
-Urokinase plasminogen activator (uPA)
-Kallikrein
What drug converts plasminogen to plasmin?
Streptokinase/Urokinase
What recombinant human tPA stimulates fibrinolysis?
Reteplase, Alteplase, Tenecteplase
Where is streptokinase cleared?
Liver
What is the half life of streptokinase?
20 minutes
What drug once given cannot be used for a year after a dose has been given and why?
Streptokinase as it forms antigenic antibodies after 4 days, and having the drug again will cause a reaction to occur.
What is Alteplase used for?
1st line for strpke, DVT and PE
Is alteplase antigenic?
NO
What is the half life of alteplase?
5 mins
How long after a Strokeevent should releplase be given?
Within 12 hours ideally less than 1 hour
How long after a Stroke event should Tenectoplase be given?
Within 6 hours, but ideally less than 1 hour
What drugs are clot selective and why?
Reteplase and Tenecteplase. They are more active on fibrin- bound plasminogen than plasma plasminogen therefore clot selective!!
How does urokinase work?
It activates circulating plasminogen, not selective for clot-bound fibrin therefore is less useful
‘uPA’
