Page 163 - pharma 1 theoretical updated MNU_Neat

Clinical pharmacy 2024/2025 Level 3 Pharm D Pharmacology 1 (PO 502)
 Plasmin dissolves fibrin clot, so called fibrin-specific.

 Both Reteplase and Teneceplase are:
➢ Longer half-lives than alteplase.
➢ Resistant to inhibition by plasminogen activator inhibitor-1.

 All drugs are similar in efficacy & safety.
 They are very expensive.

 Clinical Indications of Thrombolytics

➢ Acute myocardial infarction (acute MI):
 in patients with ST segment elevation
 < 75 years old and present within 6-12 h of starting infarction.

 The use of small dose of aspirin (75-150 mg) with thrombolytics improves their
efficacy.
 Angioplasty with or without stent placement is superior to thrombolytic therapy.

➢ Acute Pulmonary embolism:
 Thrombolytics improves pulmonary embolism if used within the first 24 h of
emolism.

➢ Acute arterial thrombosis
➢ Acute deep vein thrombosis
➢ Acute ischemic stroke (not hemorrhagic).

 Contraindications of thrombolytics

➢ Internal bleeding
➢ Stroke
➢ Uncontrolled hypertension.
➢ Surgery or trauma within the past 2 months.

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