• It is a streptococcal exotoxin ( beta hemolytic streptococci
MECHANISM OF ACTION:
– It combines with circulating–plasminogen-liberating
plasmin which breaks down fibrin
– No intrinsic enzymatic activity but forms a stable complex
with plasminogen . This complex then converts
uncomplexed plasminogen to active plasmin which causes
hydrolysis of fibrin plugs .
– Plasmin catalyses degradation of fibrinogen as well as
• ADVERSE EFFECTS
Bleeding particularly at the sites of recent trauma.
Anaphylaxis(especially when used second time in a patient)
– It should not be used if patient has had previous
streptokinase therapy within the last 12 months
– Blood pressure should be monitored.
- Acute myocardial infarction and pulmonary
- IV infusion loading dose : 250,000 units followed
by 100,000 units/hour for 24-72 hours
- this may be preceded by chlorpheniramine 10mg
and hydrocortisone 100mg to reduce allergic
reactions. This is combined with 300mg aspirin
,which should be chewed before swallowing and
followed by 150mg daily.
– Surgery within 10 days including :
• Organ biopsy
• Serious trauma
– Serious GIT bleeding within 3 months
– History of hypertension
– Hemorrhagic disorders
– Cerebrovascular accident
Aminocaproic acid (EACA)
• chemically similar to the amino acid lysine
• It competitively inhibits plasminogen
• rapidly absorbed orally and is cleared from the
body by the kidney.
• usual oral dosage :6 g four times a day.
• When administered intravenously, a 5 g
loading dose should be infused over 30
minutes to avoid hypotension.
• analog of aminocaproic acid
• administered orally with a 15 mg/kg loading
dose followed by 30 mg/kg every 6 hours
Uses of antifibrinolytic drugs
• Adjunctive therapy in hemophilia
• Bleeding from fibrinolytic therapy
• Prophylaxis for rebleeding from intracranial
• Post-surgical bleeding