Thrombolytic drug
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Overview
Thrombolytic drugs are used in medicine to dissolve blood clots in a procedure termed thrombolysis. They limit the damage caused by the blockage of the blood vessel.
Uses
Thrombolysis is used in for myocardial infarction (heart attack), ischemic strokes, deep vein thrombosis and pulmonary embolism to clear a blocked artery and avoid permanent damage to the perfused tissue (e.g. myocardium, brain, leg) and death. A less frequent use is to clear blocked catheters that are used in long-term medical therapy.
It should be noted that thrombolytic therapy in hemorrhagic strokes is contraindicated, as its use in that situation would prolong bleeding into the intracranial space and cause further damage.
Members
The thrombolytic drugs include:
- t-PA (alteplase Activase)
- reteplase (Retavase)
- tenecteplase (TNKase)
- anistreplase (Eminase)
- streptokinase (Kabikinase, Streptase)
- urokinase (Abbokinase)
These drugs are most effective if administered immediately after it has been determined they are clinically appropriate. The advantage of administration is highest within the first ninety minutes, but may extend up to six hours after the start of symptoms.
The drugs are often given in combination with intravenous heparin, or low molecular weight heparin, which are anticoagulant drugs.
Side-effects
Hemorrhagic stroke is a rare but serious complication of thrombolytic therapy. If a patient has had thrombolysis before, an allergy against the thrombolytic drug may have developed (especially after streptokinase). If the symptoms are mild, the infusion is stopped and the patient is commenced on an antihistamine before infusion is recommenced. Anaphylaxis generally requires immediate cessation of thrombolysis.
See also
Major Drug Groups | |
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| Gastrointestinal tract (A) | Antacids • Antiemetics • H₂-receptor antagonists • Proton pump inhibitors • Laxatives • Antidiarrhoeals |
| Blood and blood forming organs (B) | Anticoagulants • Antiplatelets • Thrombolytics |
| Cardiovascular system (C) | Antiarrhythmics • Antihypertensives • Diuretics • Vasodilators • Antianginals • Beta blockers • Angiotensin converting enzyme inhibitors • Antihyperlipidemics |
| Skin (D) | Emollients - Antipruritics |
| Reproductive system (G) | Hormonal contraception • Fertility agents • Selective estrogen receptor modulators • Sex hormones |
| Endocrine system (H) | Anti-diabetics • Corticosteroids • Sex hormones • Thyroid hormones |
| Infections and Infestations (J, P) | Antibiotics • Antivirals • Vaccines • Antifungals • Antiprotozoals • Anthelmintics |
| Malignant and Immune disease (L) | Anticancer agents • Immunostimulators • Immunosuppressants |
| Muscles, Bones, and Joints (M) | Anabolic steroids • Anti-inflammatories • Antirheumatics • Corticosteroids • Muscle relaxants |
| Brain and Nervous system (N) | Anesthetics • Analgesics • Anticonvulsants • Mood stabilizers • Anxiolytics • Antipsychotics • Antidepressants • Nervous system stimulants • Sedatives |
| Respiratory system (R) | Bronchodilators • Decongestants • Antihistamines |
Electrocardiography | |
|---|---|
| Overview | History of the EKG • EKG interpretation basics • Normal sinus rhythm |
| EKG Complexes | P wave • QRS complex • ST Segment • T wave • U wave Osborn wave • H wave • K wave • Delta wave |
| EKG Intervals | PR Interval • QRS Interval • ST Interval • QT Interval |
| Conduction System & Bradycardia | Cardiac pacemaker • SA node • AV node• Bundle of His • Purkinje fibers • Sinus bradycardia • First Degree AV Block • Second Degree AV Block • Complete or Third-Degree AV Block • Concealed conduction • AV Junctional Rhythms • LBBB • LAHB • LPHB • RBBB • Trifascicular block |
| Atrial Arrhythmias | Sinus tachycardia • Premature Atrial Contractions (PACs) • Ectopic Atrial Rhythm • Paroxysmal Atrial Tachycardia (PAT) • Paroxysmal Atrial Tachycardia (PAT) with Block • Multifocal Atrial Tachycardia (MAT) • Atrial Flutter • Atrial Fibrillation • Wandering atrial pacemaker |
| Ventricular Arrhythmias | Differential Diagnosis of Tachycardia with a Wide QRS Complex • Accelerated Idioventricular Rhythm • Ventricular Parasystole • Premature Ventricular Contractions (PVCs) • Ventricular tachycardia • Ventricular Fibrillation • Sudden cardiac death |
| EKG Abnormalities in Disease States | Hypertrophy & Dilatation • Right atrial enlargement • Left atrial enlargement • Biatrial enlargement • Left Ventricular Hypertrophy • Right Ventricular Hypertrophy • Biventricular Hypertrophy •
Acute myocardial infarction • NSTEMI • STEMI • Right ventricular myocardial infarction • Atrial infarction Pre-excitation Syndromes • Wolff-Parkinson-White Syndrome • Lown Ganong Levine Syndrome • Mahaim Type Preexcitation Cardiomyopathies • Arrhythmogenic Right Ventricular Dysplasia • Dilated Cardiomyopathy • Hypertrophic Cardiomyopathy Drug Effects on the EKG • Adenosine • β-blockers • Digitalis • Quinidine • Procainamide • Disopyramide • Lidocaine • Tocainide and Mexiletine • Phenytoin • Encainide, Flecainide and Propafenone • Amiodarone • Bretylium • Ca Channel Blockers • Phenothiazines • Tricyclic Antidepressants • Lithium Congenital Heart Disease • Dextrocardia • Atrial Septal Defect • Ventricular Septal Defect • Tetralogy of Fallot • Conjoined Twins or Siamese Twins • Congenital heart block Electrolyte Disturbances • Hyperkalemia • Hypokalemia • Hypercalcemia • Hypocalcemia • Nonspecific Changes Other Heart Diseases • Pericarditis • Myocarditis • Tamponade • Heart Transplantation • Sick Sinus Syndrome • Long QT Syndrome Inherited Disease • Brugada Syndrome Systemic Diseases • CNS Disease • Cardiac Tumors Heart Transplantation • EKG Changes in patient with Heart Transplantation Exogenous Effects • Hypothermia • Chest Trauma • Insect Bites • Electric Injuries |
| Technical Issues and Potential Errors in Interpretation | Artifacts • Lead Placement Errors • The EKG in a Patient with a Pacemaker • EKG in athletes |
Circulatory system pathology (I, 390-459) | |
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| Hypertension | Hypertensive heart disease - Hypertensive nephropathy - Secondary hypertension (Renovascular hypertension) |
| Ischaemic heart disease | Angina pectoris (Prinzmetal's angina) - Myocardial infarction (heart attack) - Dressler's syndrome |
| Pulmonary circulation | Pulmonary embolism - Cor pulmonale |
| Pericardium | Pericarditis - Pericardial effusion - Cardiac tamponade |
| Endocardium/heart valves | Endocarditis - mitral valve (regurgitation, prolapse, stenosis) - aortic valve (stenosis, insufficiency) - pulmonary valve (stenosis, insufficiency) - tricuspid valve (stenosis, insufficiency) |
| Myocardium | Myocarditis - Cardiomyopathy (Dilated cardiomyopathy, Hypertrophic cardiomyopathy, Loeffler endocarditis, Restrictive cardiomyopathy) - Arrhythmogenic right ventricular dysplasia |
| Electrical conduction system of the heart | Heart block: AV block (First degree, Second degree, Third degree) - Bundle branch block (Left, Right) - Bifascicular block - Trifascicular block Pre-excitation syndrome (Wolff-Parkinson-White, Lown-Ganong-Levine) - Long QT syndrome - Adams-Stokes syndrome - Cardiac arrest - Sudden cardiac death Arrhythmia: Paroxysmal tachycardia (Supraventricular, AV nodal reentrant, Ventricular) - Atrial flutter - Atrial fibrillation (Familial) - Ventricular fibrillation - Premature contraction (Atrial, Ventricular) - Ectopic pacemaker - Sick sinus syndrome |
| Other heart conditions | Heart failure - Cardiovascular disease - Cardiomegaly - Ventricular hypertrophy (Left, Right) |
| Cerebrovascular diseases | Stroke - Transient ischemic attack - Intracranial hemorrhage/cerebral hemorrhage: Extra-axial hemorrhage (Epidural hemorrhage, Subdural hemorrhage, Subarachnoid hemorrhage) Intra-axial hematoma (Intraventricular hemorrhages, Intraparenchymal hemorrhage) - Anterior spinal artery syndrome - Binswanger's disease - Moyamoya disease |
| Arteries, arterioles and capillaries | Atherosclerosis (Renal artery stenosis) - Aortic dissection/Aortic aneurysm (Abdominal aortic aneurysm) - Aneurysm - Raynaud's phenomenon/Raynaud's disease - Buerger's disease - Vasculitis/Arteritis (Aortitis) - Intermittent claudication - Arteriovenous fistula - Hereditary hemorrhagic telangiectasia - Spider angioma - Dissection (Carotid artery, Vertebral artery) |
| Veins, lymphatic vessels and lymph nodes | Thrombosis/Phlebitis/Thrombophlebitis (Deep vein thrombosis, May-Thurner syndrome, Portal vein thrombosis, Venous thrombosis, Budd-Chiari syndrome, Renal vein thrombosis, Paget-Schroetter disease) - Varicose veins / Portacaval anastomosis (Hemorrhoid, Esophageal varices, Varicocele, Gastric varices, Caput medusae) - Superior vena cava syndrome - Lymph (Lymphadenitis, Lymphedema, Lymphangitis) |
| Other | Hypotension (Orthostatic hypotension) - Rheumatic fever |
| See also congenital (Q20-Q28, 745-747) | |
WikiDoc Research Resources for Thrombolytic drug | |
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| Articles on Thrombolytic drug | Most recent articles on Thrombolytic drug • Most cited articles on Thrombolytic drug • Review articles on Thrombolytic drug • Articles on Thrombolytic drug in N Eng J Med, Lancet, BMJ |
| Media (Slides, Video, Images, MP3) on Thrombolytic drug | Powerpoint slides on Thrombolytic drug • Images of Thrombolytic drug • Photos of Thrombolytic drug • Podcasts & MP3s on Thrombolytic drug • Videos on Thrombolytic drug |
| Evidence Based Medicine Regarding Thrombolytic drug | Cochrane Collaboration on Thrombolytic drug • Bandolier on Thrombolytic drug • TRIP on Thrombolytic drug |
| Cost Effectiveness of Thrombolytic drug | Cost Effectiveness of Thrombolytic drug |
| Clinical Trials Involving Thrombolytic drug | Ongoing Trials on Thrombolytic drug at Clinical Trials.gov • Trial results on Thrombolytic drug • Clinical Trials on Thrombolytic drug at Google |
| Guidelines / Policies / Government Resources (FDA/CDC) Regarding Thrombolytic drug | US National Guidelines Clearinghouse on Thrombolytic drug • NICE Guidance on Thrombolytic drug • NHS PRODIGY Guidance • FDA on Thrombolytic drug • CDC on Thrombolytic drug |
| Textbook Information on Thrombolytic drug | Books and Textbook Information on Thrombolytic drug |
| Pharmacology Resources on Thrombolytic drug | Dosing of Thrombolytic drug • Drug interactions with Thrombolytic drug • Side effects of Thrombolytic drug • Allergic reactions to Thrombolytic drug • Overdose information on Thrombolytic drug • Carcinogenicity information on Thrombolytic drug • Thrombolytic drug in pregnancy • Pharmacokinetics of Thrombolytic drug • |
| Genetics, Pharmacogenomics, and Proteinomics of Thrombolytic drug | Genetics of Thrombolytic drug • Pharmacogenomics of Thrombolytic drug • Proteomics of Thrombolytic drug |
| Newstories on Thrombolytic drug | Thrombolytic drug in the news • Be alerted to news on Thrombolytic drug • News trends on Thrombolytic drug |
| Commentary on Thrombolytic drug | Blogs on Thrombolytic drug |
| Patient Resources on Thrombolytic drug | Patient resources on Thrombolytic drug • Discussion groups on Thrombolytic drug • Patient Handouts on Thrombolytic drug • Directions to Hospitals Treating Thrombolytic drug • Risk calculators and risk factors for Thrombolytic drug |
| Healthcare Provider Resources on Thrombolytic drug | Symptoms of Thrombolytic drug • Causes & Risk Factors for Thrombolytic drug • Diagnostic studies for Thrombolytic drug • Treatment of Thrombolytic drug |
| Continuing Medical Education (CME) Programs on Thrombolytic drug | CME Programs on Thrombolytic drug |
| International Resources on Thrombolytic drug | Thrombolytic drug en Espanol • Thrombolytic drug en Francais |
| Business Resources on Thrombolytic drug | Thrombolytic drug in the Marketplace • Patents on Thrombolytic drug |
| Informatics Resources on Thrombolytic drug | List of terms related to Thrombolytic drug |
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Acknowledgement and Attribution Regarding Sources of Content
Some of the initial content on this page may be incorporated in part from copyleft sources in the public domain including wikis such as Wikipedia and AskDrWiki. Drug information for patients came from the The National Library of Medicine. Infectious disease information may have come from the Centers for Disease Control (CDC). Differential Diagnoses are drawn from clinicians as well as an amalgamation of 3 sources: 1.The Disease Database; 2. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:3; 3. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:7 .
