STREPTOKINASE

Indications & Dose:

Acute myocardial infarction

• BY INTRAVENOUS INFUSION

Adult: 1 500 000 units, to be initiated within 12 hours of symptom onset, dose to be given over 60 minutes

Deep-vein thrombosis

Pulmonary embolism

Acute arterial thromboembolism

Central retinal venous or arterial thrombosis l

• BY INTRAVENOUS INFUSION

Adult: 250 000 units, dose to be given over 30 minutes, then 100 000 units every 1 hour for up to 12–72 hours, duration is adjusted according to condition with monitoring of clotting parameters (consult product literature)

Children

Not recommended.

Contraindications:

Active internal bleeding; recent (within 2 mo) CVA; intracranial or intraspinal surgery, intracranial neoplasm; severe uncontrolled hypertension

Side Effects:

CNS: Fever, headache

CV: Hypertension, reperfusion dysrhythmias

EENT: Periorbital edema

GI: Nausea, vomiting

HEME: Anemia, bleeding (GI, GU, intracranial, retroperitoneal, surface)

RESP: Altered respirations, bronchospasm, lion-cardiogenic pulmonary edema, shortness of breath

SKIN: Flushing, itching, phlebitis at IV INF site, rash, urticaria

MISC: Chills, sweating

Cautions:

Precautions:

Recent (within 10 days) surgery, obstetrical delivery, organ biopsy, trauma including CPR; high likelihood of left heart thrombus (e.g., mitral stenosis with atrial fibrillation); subacute bacterial endocarditis; hemostatic defects; age >75 yr; diabetic hemorrhagic retinopathy; septic thrombophlebitis or infected occluded AV cannula at seriously infected site; recent streptococcal infection; repeat administration (between 5 days and 12 mo of prior streptokinase), possibility of preexisting thrombus as in abdominal aneurysm or enlarged left atrium with atrial fibrillation (risk of dissolution of clot and subsequent embolization), recent of concurrent anticoagulant therapy

. Pregnancy; no data available for breast feeding

Interaction:

Drugs Heparin, oral anticoagulants, drugs that alter platelet function (i.e., aspirin, dipyridamole, ahciximab, eptifibitide, tirofiben): May increase the risk of bleeding

Warnings:

Adverse Effects:

Lactations:

Special Precautions:

Counselling:

Side Effects Or Adverse Reactions:

Patient And Carer Advice: