Thrombolytics: Types and Dosages Explained
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ScribdTranslationsThrombolytics: Types and Dosages Explained
Translated by
ScribdTranslationsTHROMBOLYTICS
Thrombolytic drugs are substances that enhance fibrinolysis with the
the objective of recanalizing a vessel obstructed by a thrombus, whether it is arterial or venous.
In general, they are direct or indirect activators of plasminogen, which stimulate
its conversion into plasmin.
Classification according to their mechanism of action
Thrombolytic agents are classified into three main groups. Depending on their
specificity of fibrinolysis in the area where a thrombus has formed.
1) Non-specific agents or fibrinolytics
They stimulate fibrinolysis where plasminogen exists, both in the vicinity of
thrombus as in the rest of the blood circulation. The following are included in this group:
STREPTOKINASE (SK): It binds to circulating plasminogen, increasing
its sensitivity to endogenous plasminogen activators, so it
plasma forms more quickly and in greater quantity.
Route of administration and dosage
Adults
Intravenous infusion. Acute coronary thrombosis, 1,500,000 IU administered
for 60 minutes.
Other indications. Initial, 250,000 IU administered over 30 minutes, followed by
an infusion of 100,000 IU/h for 24 to 72 hours.
Intracoronary. Initial, 20,000 IU, followed by an infusion of 2,000 IU/min for
60 minutes.
In all cases, prepare the solution as indicated by the manufacturer.
PRESENTATION
STREPTASE. AVENTIS PHARMA. Lyophilized for injectable solution. Each drug
contains 250,000, 750,000, 1,500,000 UI of streptokinase. One or ten vials
ampule with 250,000, 750,000, 1,500,000 IU of streptokinase.
UROKINASE (UK): Stimulates the hydrolysis of plasminogen and converts it into
plasmin, even without the participation of endogenous activators.
ROUTES OF ADMINISTRATION AND DOSAGE
Adults
Intravenous. 1.5 million IU in infusion for 90 minutes
2) Intermediate specificity agents
This group of medium specificity includes the:
ANISTREPLASA: acylated streptokinase-plasminogen complex (APSAC)
INDICATIONS: For the acute treatment of myocardium due to thrombosis
coronary.
Routes of administration and dosage
Adults
Intravenous. 30 IU in a single intravenous bolus, injected over 2 to 5 minutes.
PRESENTATION
IMINASE.30 U 1 VIAL. MADAUS CERAFARM
3) Specific agents or thrombolytics proper
They stimulate the fibrinolytic process only in areas where there is fibrin.
thrombus and not in the systemic circulation). Among them stands out:
Recombinant tissue plasminogen activator (rt-PA) or ALTEPLASE
RETEPLASE: It must bind to fibrin to latch onto plasminogen and
transform it into plasmin.
ROUTES OF ADMINISTRATION AND DOSAGE
Adults
Intravenous infusion. Acute myocardial infarction, the recommended dose for
patients with a body weight of 67 kg is 100 mg.
90-minute regimen, starting within the first 6 hours of the onset of the infarction
with a bolus of 15 mg followed by an infusion of 50 mg over 30 minutes,
followed by 35 mg in infusion over 60 minutes (maximum 100 mg). In patients
with a weight of less than 67 kg, the recommended dose is a bolus of 15 mg, followed by
an infusion of 0.75 mg/kg (not exceeding 50 mg) for 30 minutes; after that,
infusion of 0.50 mg/kg (not exceeding 35 mg) over the next 60 minutes.
3-hour regimen. The recommended dose is 100 mg starting between 6 and 12 hours.
from the IAM. Administer 60 mg during the first hour, of which 6 10 mg in form
from intravenous drip during the first 1 to 2 minutes. During the second hour
administer 20 mg and finally during the third hour administer the last 20 mg.
In patients weighing less than 65 kg, the recommended dose is 1.25 mg/kg.
of weight, manage as indicated before.
Presentation
[Link] INGELHEIM PROMECO. Injectable solution. The ampoule vial with
Lyophilized contains 50 mg of ALTEPLASE and the vial ampoule with diluents.
It contains 50 ml of sterile injectable water. Each package contains 2 ampoule vials.
with freeze-dried, 2 ampoule vials with diluent and an instruction manual.
TENECTEPLASE (TNK-t-PA): +antiglycoprotein IIb/IIIa
PROUROCINASA (pro-UK): It is an inactive molecule that needs
transforms into UK, but this only happens in the presence of fibrin and, therefore
so much, around a thrombus.