Thrombolytics

Thrombolytics, unlike anticoagulants and antiplatelets, will actually dissolve a clot. We are going to break them down into two categories: Direct acting and indirect acting.

Direct Acting

• Urokinase (Abbokinase) – inj – tends to be utilized when we need to open a clotted central line catheter.
• Alteplase (Activase) – inj – is used for very serious life threatening conditions such as:
  • Pulmonary embolism
  • Myocardial infarction: Only works for the first few hours of a heart attack.  Unfortunately a lot of people are in denial in the beginning of a heart attack.
  • Stroke (clot): The stroke could be caused by a clot or by the opposite, bleeding. If you use this drug in a bleeding situation, death.

Indirect Acting

• Streptokinase (Streptase) – inj – is dependent on the plasminogen in the bloodstream.  Streptokinase stimulates conversion of plaminogen to plasmin.  Plasmin is our bodies internal thrombolytic.  Streptokinase is used for pulmonary embolism.