streptokinase group
Post on 04-Jan-2016
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Streptokinase
Streptokinase:
Is a protein secreted by several streptococci, it can bind & activate human plasminogen to convert to plasmin.
Generic name : Streptokinase.
Brand (trade) name:
Kabikinase, Streptas ( names registered medication in Saudi Arabia according to FDA).
Therapeutic class :
Thrombolytic enzyme.
Pharmacologic class :Tissue Plasminogen Activator .
Pharmacology:Converts plasminogen to the enzyme plasmin, which aids in dissolution of blood clots. Available forms:
The only available form is powder.
Administration:1-IV ( intravenous route ) .
2-IC ( intracoronary route ).Action:Dissolve clot that have formed in blood vessels.
Storage/Stability:Store unopened vials at controlled room temperature (59° to 86°F). Use reconstituted solution immediately or within 8 h if stored at 36° to 46°F. Discard any unused solution.
Pharmacokinetics Metabolism:No metabolites identified. Elimination:Streptokinase is cleared by the liver. The half life is approximately 23 .
Indications & usage:
1 -AMI . lysis of intracoronary thrombi → improvement of ventricular
function, and reduction of mortality associated with acute MI; reduction of infarct size and CHF associated with acute MI.
2-Pulmonary Embolism .
3-DVT.
acute, extensive thrombi of the deep veins (eg, those involving the popliteal vessels); lysis of acute arterial thrombi and emboli; alternative to surgical revision for clearing totally or partially occluded arteriovenous cannula when acceptable flow cannot be achieved.
Dosage and Administration Acute MI (Adults): IV infusion Administer ASAP after symptom onset (greatest benefit when administered within 4 h, but benefit has been reported up to 24 h). Infuse a total dose of 1,500,000 units within 60 min. Intracoronary infusion Administer 20,000 units by bolus followed by 2000 units/min for 60 min (total dose, 140,000 units). PE , DVT, Arterial Thrombosis, or Embolism (Adults): IV infusion Administer ASAP after onset of thrombotic event, preferably within 7 days. A loading dose of 250,000 units infused into a peripheral vein over 30 minutes has been found appropriate in over 90% of patients.
Nursing consideration:1 Monitor Coagulation profile.
2-checking ECG & Vital signs 3-Be aware if patient has had either recent streptococcal infection
or recent treatment with streptokinase, higher loading dose may be necessary.
4-Check hypersensitivity reactions, give 100 unit intradermal, as ordered; wheal & flare response within 20 minutes means patient is probably allergic.
5-Notify doctor immediately if hypersensitivity occur.6-Keep corticosteroids and aminocaproic acid available to treat
allergic reaction and bleeding.
Contraindications:1-Active internal bleeding.2- Recent cerebrovascular accident (within 2 months).3- Intracranial or intraspinal surgery4- Severe uncontrolled hypertension.
Side Effect:
1- Bleeding.2-Allergic reaction.3-Sever kidney disease.4-Dameg to the blood vessels and others.
Notify the doctor immediately if the patient complain of any of the following:1-Blurred Vision.2-Dizziness.3-Fever.4-Sweating.
Antidote of Streptokinase:
Aminocaproic acid.
Thank you
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