Question

write a paper on thrombolytic drugs

Answer 1

A) Thrombolytic drugs

What are the components of thrombus?

1. Platelet
2. Red blood cells
3. Fibrin - fibrin creates a net in which platelets and RBC are trapped.

B) Thrombolytic drugs - This group of drugs degrades fibrin.

C) Mechanism of action - They degrade fibrin by activating the plasminogen.

Tissue plasminogen activator stimulates Plasminogen.

Plasminogen is converted to plasmin.

Plasmin breaks down fibrin into fibrin degradation products

D) Examples of thrombolytic drugs

1. Streptokinase
2. Alteplase
3. Reteplase
4. Tenecteplase
5. Urokinase
6. Anistreplase

E) Indication of Thrombolytic drugs

1. ST-segment elevation Myocardial infarction
2. Pulmonary thromboembolism associated with shock ( systolic BP < 90 mmHg)
3. Acute ischemic stroke
4. Deep venous thrombosis
5. Acute peripheral arterial occlusion
6. Occlusion of indwelling catheters

F) ContraIndication

• Absolute contraindication

1. Previous hemorrhagic stroke
2. Intracranial neoplasm
3. Suspected aortic dissection
4. Internal bleed within 6 weeks
5. Major surgery/ trauma in the past 6 weeks
6. Bleeding disorder
7. Head trauma/ brain surgery in the past 6 months
8. History of stroke, brain damage, dementia in the past 1 year

• Relative contraindication

1. Pancreatitis, Peptic ulcer, Pulmonary tuberculosis, Pregnancy
2. Intracardiac thrombi, infective endocarditis, Transient ischemia attack
3. Liver disease

G) Comparison of thrombolytic agents

	Streptokinase	Alteplase	Reteplase	Tenecteplase
Bolus	NO	NO	YES	YES
ANTIGENIC	YES	NO	NO	NO
ALLERGIC REACTION	YES	NO	NO	NO
Systemic depletion of fibrinogen	Marked	Mild	Moderate	Minimal
90 min patency rate(%)	50	75	75	75