Streptokinase, 1500000 me

Streptokinase is an enzyme preparation obtained from a culture of b-hemolytic group C streptococcus. The drug has fibrinolytic activity, which is due to the ability to interact with blood plasminogen. Streptokinase complex with plasminogen has proteolytic activity and catalyzes the transformation of plasminogen into plasmin.

The latter is able to cause lysis of fibrin in blood clots, inactivate fibrinogen as well as factors V and VII of blood clotting. Streptokinase activity is determined by the ability of the drug to lysis under certain conditions the fibrin clot formed by a mixture of fibrinogen and thrombin solutions, and is expressed in international (international) units (IU or IU).

Streptokinase is used to restore patency of thrombosed blood vessels; the drug causes lysis of clots, acting on them not only from the surface, but also penetrating inside the thrombus (especially for fresh thromboses).

Pharmacokinetics

The elimination half-life after intravenous administration of 1500000 IU streptokinase is 1 hour; the streptokinase-plasminogen complex is about 23 minutes. It is biotransformed in the liver by hydrolysis. It is excreted in small amounts by the kidneys. In liver diseases clearance is delayed, renal failure does not affect clearance.

Indications

embolism of the pulmonary artery and its branches,
thrombosis and embolism of peripheral arteries,
thrombosis of superficial and deep veins (extremities, pelvis),
acute myocardial infarction (within the first 12 hours),
thrombosis of the vessels of the retina and other conditions occurring with acute embolism and thrombosis or with the threat of blood clots.

Pharmacological effect

Streptokinase is an enzyme preparation obtained from a culture of b-hemolytic streptococcus group C. The drug has fibrinolytic activity, which is due to the ability to interact with blood plasminogen. The complex of streptokinase with plasminogen has proteolytic activity and catalyzes the conversion of plasminogen to plasmin.

The latter is capable of causing lysis of fibrin in blood clots, inactivating fibrinogen, as well as factors V and VII of blood clotting. Streptokinase activity is determined by the ability of the drug to lyse, under certain conditions, a fibrin clot formed by a mixture of fibrinogen and thrombin solutions, and is expressed in international units (IU or IU).

Streptokinase is used to restore the patency of thrombosed blood vessels; the drug causes lysis of blood clots, acting on them not only from the surface, but also penetrating inside the blood clot (especially with fresh blood clots).

Pharmacokinetics

The half-life after intravenous administration of 1,500,000 IU of streptokinase is 1 hour, the streptokinase-plasminogen complex is about 23 minutes. Biotransformed in the liver by hydrolysis. Excreted in small quantities by the kidneys. In liver disease, clearance is slowed; renal failure does not affect clearance.

Special instructions

Treatment is carried out under the control of thrombin or partial thromboplastin time. Use with extreme caution in cases of severe liver and kidney dysfunction, diabetes mellitus, bronchial asthma, previous streptococcal infection, including rheumatism, bronchiectasis with hemoptysis, dilation of the esophageal veins, recent prescription of anticoagulants, conditions after cardiopulmonary resuscitation, mechanical ventilation, bleeding accompanying urological diseases, including urolithiasis, as well as chronic diseases of the gastrointestinal tract, menorrhagia, menstrual bleeding, previously (from 5 days to 1 year) a course of treatment with streptokinase, in old age (over 75 years).

The drug is used in a hospital setting.

Active ingredient

Streptokinase

Composition

1 bottle contains:

streptokinase 1500000 IU.

Contraindications

The drug is contraindicated in:

acute bleeding,
hemorrhagic diathesis,
fresh ulcers of the gastrointestinal tract,
after recent operations,
with severe hypertension,
septic endocarditis,
cerebrovascular disorders,
pulmonary tuberculosis (cavernous forms),
in the first trimester of pregnancy.

Side Effects

When using streptokinase, nonspecific reactions to protein may develop: headache, nausea, chills, allergic reactions (for severe allergic reactions, the use of corticosteroids is recommended).

With rapid intravenous administration, hypotension and cardiac arrhythmia may develop. The possibility of embolism (due to the mobilization of thrombus elements) should be taken into account.

Interaction

Heparin, coumarin derivatives, dipyridamole, NSAIDs, including acetylsalicylic acid, dextrans, valproic acid enhance the anticoagulant effect and increase the risk of bleeding.

Incompatible with plasma replacement solutions – hydroxyethyl starch and dextran.

Overdose

Symptoms: increased side effects (most often bleeding)

Treatment: stop bleeding (if possible), prescribe antifibrinolytic agents (tranexamic acid, para-aminomethylbenzoic acid, kallikrein or protease inhibitors, including aprotinin, aminocaproic acid – 5 g/hour, then 1 g/hour for 4-8 hours until the effect is achieved), replacement of blood loss (except for dextran and hydroxyethyl starch), symptomatic treatment.

Storage conditions

In a dry place, at a temperature not exceeding 25 °C

Shelf life

5 years

Manufacturer

Belmedpreparaty, Belarus