Class: Thrombolitics

Mechanism Of Action: Acts with plasmogen to produce an activator complex which convert plasmogen to enzyme plasmin. Digests fibrin and fibrinogen, resulting in dissolution of clots that coronary artery occlusion.

Indication: Acute MI

Contraindications:

ABSOLUTE:

                     Active internal bleeding.

                     Suspected aortic dissection.

                     Traumatic CPR(rib fracture, pneumothorax).

                     Severe persistent hypotension.

                     Recent head trauma or known intracranial tumor.

                     History of stroke in the last 6 months

                     Pregnancy

RELATIVE:

                     History of trauma/major surgery in past 12 months.

                     Initial BP > 180 systolic or > 110 diastolic that is controlled by medical Tx.

                     Active peptic ulcer or blood in stool.

                     History of stroke, tumor, brain surgery, or head injury.

                     Known bleeding disorder or current use of coumadin

                     Significant liver dysfunction or kidney failure.

                     Prolonged CPR.

Precaution: Reperfusion arrhythmias are common once occlusion is opened.

Side Effects: Bleeding/allergic reaction/anaphylaxsis/fever

Dosage:

Streptokinase: 1.5 million units over 1 hour IV

TPA (Activase): 15mg IV bolus over 1-2 min

                           50mg IV infusion over 1^st hour, then 35mg over 2^nd hour.

Max: 100mg