It is also called as fibrinolytic therapy

2.  Thrombolytic agent is a treatment to dissolve
dangerous clots in blood vessels, improve blood flow,
and prevent damage to tissues and organs.
 The thrombolytic agents available today are serine
proteases that work by converting plasminogens to the
natural fibrinolytic agent plasmin. Plasmin lyses clot
by breaking down the fibrinogen and fibrin contained
in a clot.

3. DEFINITION
Thrombolysis is a process or a form of treatment with a
primary goal of the dissolving blood clots that cause
obstruction. This is a common form of treatment that can
assist clients who are suffering from blood clots. This can
also facilitate improvement of one’s blood flow.

4.  Streptokinase:
 ST elevation myocardial infarction
 Arterial thrombosis
 DVT
 Pulmonary embolism
 Intra- arterial or intravenous catheter
occlusion

5.  History of chronic, severe, poorly controlled
hypertension.
 History of prior ischemic stroke
 Dementia
 Recent internal bleeding
 No compressible vascular punctures
 Pregnancy
 Current use of an anticoagulant (warfarin)

6.  Fibrinolytic agents are divided into 2
categories:
 fibrin- specific agents
 Non- fibrin- specific agents

7.  Fibrin- specific agents: include alteplase (tPA),
reteplase (recombinant plasminogen activator [r-PA],
and tenecteplase produce limited plasminogen
conversion in the absence of fibrin.
 Non-fibrin specific agents: eg: streptokinase catalyze
systemic fibrinolysis.

8.  The most commonly used clot-busting drugs also
known as thrombolytic agents include:
 Eminase (anistreplase)
 Retavase ( reteplase)
 Sreptase (streptokinase)
 T-PA
 TNKase
 abbokinase

9. THROMBOLYSIS USES
• There are a number of uses of the thrombolytic agents in a
specific manner. The following are the said uses of the drugs:
STREPTOKINASE
• The said agent will remain in the patient’s body and provide a
chronic or lasting treatment for three to six months.
• ST elevation in myocardial infarction. This is found or identified
in ECG results. Those who had an ST elevation are required to
take such medication.
• Those suffering from arterial thrombosis and deep vein
thrombosis. These are common conditions of the elderly and
those who are prone to blood clot formation.
• Patients with acute pulmonary embolism are treated with
streptokinase

10. TENECTEPLASE
This is modified form of tPA or tissue plasminogen
activator that shall convert plasminogen to plasmin.
•Those suffering from an acute MI or myocardial infarction
are provided with such medication

11. UROKINASE
This type of thrombolytic agent has a number of uses.
•This is provided to clients who have had myocardial
infarction.
•Occlusion of a catheter can be treated with this drug.
•Deep vein thrombosis is also relieved by this drug.
•During dialysis this drug is used to avoid or be a form of
prophylaxis for thrombus formations

12. THROMBOLYSIS MECHANISM
• The basic action of thrombolysis is to dissolve the formed blood
clots or clinically known as lysing the thrombi.
• As an agent is administered, it would start its role by activating
plasminogen.
• Plasmin is capable in breaking down the integrity of the blood
clot formation.
• Plasminogen would serve as an activator and assistance in the
process of thrombosis.
• Plasmin is capable of breaking down the molecules responsible in
holding together the blood clot, known as the fibrin molecules.
• As the action of plasmin is taken part, breaking down the clot
formations is easily attained.

13.  T-PA
1. Acute myocardial infarction
2. Acute cerebrovascular thrombosis
3. Pulmonary embolism
4. Central venous catheter occlusions

14. Thrombolysis Guidelines
• It would involve its use and indications.
• This is not provided abruptly as one is suspected
to be problems with blood clot formation.
• There are indications to be considered before
prescribing the drug.
• This is to make precautions as this drug is not to
be abused.

15.  Non- cardiogenic pulmonary edema
 Hypotension
 Fever and shivering
 History of cerebrovascular hemorrahage
 marked hypertension (SAP> 180mm of hg/ DAP>
110 mm of hg)
 Suspicion of aortic dissection
 Active internal bleeding

16.  Severe high blood pressure
 Active bleeding or severe blood loss
 hemorrhagic stoke from bleeding in the brain.
 Severe kidney disease
 Recent surgery
 Bruising or bleeding at the access site
 Damage to the blood vessel
 Migration of the blood clot to another part of vascular
system.
 Kidney damage in pts with diabetes.