NUR 3251 Pharm II Exam

Streptokinase • was the agent associated with the slowest rate of clot lysis (p = 0.01 vs urokinase and rt-PA). • Urokinase was associated with an intermediate rate of lysis but appeared to be the agent with the grea ...

Streptokinase • was the agent associated with the slowest rate of clot lysis (p = 0.01 vs urokinase and rt-PA). • Urokinase was associated with an intermediate rate of lysis but appeared to be the agent with the greatest degree of fibrinolytic specificity (p = 0.02 vs streptokinase, p = 0.05 vs rt-PA How do thrombolytic agents differ from anticoagulants? • To break a clot, you need a thrombolytic like tPA or Streptokinase. • Antiplatelets work by preventing platelets from clumping and forming a clot. • Anticoagulants don't work on platelets. They do their work by inhibiting clotting factors which are part of the coagulation cascade. What are the indications for the use of thrombolytics? • Thrombolytic therapy is the use of drugs to break up or dissolve blood clots, which are the main cause of both heart attacks and stroke What are contraindications to the use of thrombolytics? • Active bleeding or bleeding diathesis (excluding menses) Significant closed head trauma or facial trauma within 3 months. • Intracranial or intraspinal surgery within 2 months. Severe uncontrolled hypertension (unresponsive to emergency therapy) Are thrombolytics contraindicated in pregnancy? • During pregnancy, the hazards of thrombolysis lie in the risks of fetal and maternal bleeding, fetal-maternal death, teratogenicity, and placental abruption. • The basis for fetal safety must rely on what is known regarding drug entry into the placenta What are adverse effects of thrombolytics? Besides risk of serious internal bleeding, other possible risks include: • 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 patients with diabetes or pre-existing kidney disease