Description of the medicine: Fibrinolysin (Fibrinolysinum)
Fibrinolysin (or plasmin) is an enzyme that forms when plasminogen (profibrinolysin) is contained in the blood.
Fibrinolysin (plasmin) is a physiological component of the body's natural anticoagulant system. The basis of the action of the enzyme is its ability to dissolve fibrin filaments. This effect is observed in vitro and in vivo. By the nature of the action, fibrinolysin can be considered as tissue proteinase (tissue proteolytic enzyme). The effect of fibrinolysin on fresh fibrin clots before their retraction is most pronounced. In connection with these properties, fibrinolysin is used to treat diseases accompanied by intravascular prolapse of fibrin clots and the formation of blood clots.
Fibrinolysin is obtained from profibrinolysin in human blood plasma during its enzymatic activation with trypsin. White hygroscopic powder. Soluble in isotonic sodium chloride solution.
The activity of the drug is determined biologically, by the ability to cause lysis of a fresh standard clot of fibrinogen and is expressed in units of action (UNIT).
Fibrinolysin is used in cases of fresh thrombosis (within 1 day with thrombosis of the coronary vessels and blood vessels of the brain and with thrombosis of the peripheral arterial branches, if gangrene has not occurred; within 5-7 days with thrombosis of peripheral veins). With an increase in the lifetime of the thrombus, the effectiveness of fibrinolysin decreases.
Currently, due to the widespread introduction of streptokinase preparations into practice, which have a more permanent fibrinolytic effect with fewer side effects; fibrinolysin is used relatively rarely.
In therapeutic doses, fibrinolysin does not affect the blood coagulation process, therefore it should be used in combination with anticoagulants (heparin). Heparin prevents further blood clots and ensures the effectiveness and safety of therapy. The need for the use of fibrinolysin together with anticoagulants is also determined by the fact that, according to available data, fibrinolysin can cause activation of the blood coagulation system; in addition, after the introduction of fibrinolysin, an increase in the antifibrinolytic properties of blood is possible.
When combined with fibrinolysin, heparin is administered in lower doses than when used alone. Indirect anticoagulants (dicumarin and phenyline groups) may also be used; they are used immediately after administration of fibrinolysin and heparin.
The drug is administered intravenously drip. Fibrinolysin, which is in a dry form in a vial, is dissolved in a sterile isotonic sodium chloride solution at the rate of 100 - 160 PIECES of the drug in 1 ml. Solutions are prepared immediately before use, since when standing (in the conditions of room temperature) they lose activity.