Name: Streptokinase (Streptase)
Class: Antithrombotic Agent (Thrombolytic Agent)
Mechanism: Derived from b-hemolytic streptococci. Forms a complex w/plasminogen, exposing its active site. Poor thrombus specificity—catalyzes conversion of circulating and fibrin-bound plasminogen—results in a systemic lytic state.
Absorption: IV. Admin. w/large loading dose to overcome plasma antibodies.
Dist.:
Metabolism.:
Excretion, t½:
Toxicity/S.E.s: Hemorrhage. Allergic rxns—pruritis, flushing, urticaria. Higher incidence of allergic rxns. w/readministration. Pronounced hypotension (usu. transient). Delayed fever and arthralgia.
Utility: Treat acute MI (w/in 6 hr. of symptoms), massive PE, acute proximal vein thromboses, occlusion of dialysis access sites and indwelling catheters, occlusion of prosthetic heart valves.
Special Features: Best results in pts. that receive therapy < style=""> Pts. w/antibodies can develop therapeutic resistance.