Thrombolytics

Physicians trained after the advent of thrombolytic therapy may find it difficult to believe that this concept was one of the most hotly debated pathophysiological tenets of the 20th century - Marie-Germaine Bousser

Thrombolytics
Thrombolysis

image by: Donna Adamchick

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Clot Busters - Discovery of Thrombolytic Therapy for Heart Attack and Stroke

What do the search for antibiotics in the 1930s, the discovery of the double helix in the 1950s, and an extremely aggressive case of melanoma skin cancer in the 1970s have in common? They all contributed a piece of the puzzle to a breakthrough treatment for heart attacks and the most common form of stroke.

That treatment, a class of “clot busting drugs” called thrombolytics, has saved untold lives. Yet as in so much of science, the introduction of thrombolytics took a long, circuitous route, with both head-scratching bewilderment and “aha!” moments along the way. The emerging, disparate pieces did not appear to belong to the same puzzle, much less to one pertaining to the heart or…

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 Clot Busters - Discovery of Thrombolytic Therapy for Heart Attack and Stroke

The development of thrombolytics (“clot-busters”) to treat heart attack and stroke followed a complex pathway of basic research and clinical observation. Natural clot busting agents, from human blood vessels, leeches, vampire bat saliva, and bacteria all played a role in helping scientists understand how to harness the power of thrombolytics to save lives.

Care Clinical Research

Bleeding is the major complication of thrombolytic therapy. Consequently, absolute contraindications include dissecting aortic aneurysm, pericarditis, stroke, or neurosurgical procedures within 6 months or known intracranial neoplasm. Relative contraindications include major surgery or bleeding within 6 weeks, known bleeding diathesis, and severe uncontrolled hypertension. •Allergic reactions: SK and anistreplase are potentially allerogenic. Patients are usually pretreated with intravenous hydrocortisone 100 mg. •Antibody production: SK and anistreplase induce antibody production, which makes retreatment with either of these agents less effective.

Drugs.com

Thrombolytic medication is used to break up or dissolve blood clots, which are the main cause of both heart attacks and stroke.

Alteplase (Activase)

It is a tissue plasminogen activator (tPA) It enhances the conversion of plasminogen to plasmin by binding to fibrin initiating fibrinolysis with limited systemic proteolysis. The circulating plasminogen that has been activated will cause a systemic lytic state Alteplase requires fibrin as a cofactor for the activation of plasminogen.

Retavase

RETAVASE® (reteplase) is indicated for use in the management of acute myocardial infarction (AMI) in adults for the improvement of ventricular function following AMI, the reduction of the incidence of congestive heart failure, and the reduction of mortality associated with AMI. Treatment should be initiated as soon as possible after the onset of AMI symptoms.

Streptase

Streptokinase, is indicated for use in the management of acute myocardial infarction (AMI) in adults, for the lysis of intracoronary thrombi, the improvement of ventricular function, and the reduction of mortality associated with AMI, when administered by either the intravenous or the intracoronary route, as well as for the reduction of infarct size and congestive heart failure associated with AMI when administered by the intravenous route.

Tenecteplase

The only lytic delivered as a 5-second IV bolus for the treatment of acute ST elevation myocardial infarction (STEMI), TNKase® (tenecteplase) enables you to intervene quickly.

Urokinase

Urokinase is a man-made product developed using a protein that occurs naturally in the kidneys. Urokinase is a thrombolytic agent that works by dissolving blood clots.

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