Medication Description: Streptokinase (Streptokinase)
Streptokinase (Streptokinase) *.
Enzyme preparation obtained from the culture of b-hemolytic streptococcus group C.
Produced abroad under the names "Avelysin" (Аwelysin) "[Name of the drug company AWD (Arzneimittelwerk Dresden GmbH Germany)]," Streptase "(Streptase)," Kabikinaz "(Kabikinase) [The previously released domestic drug Streptoliasis was excluded from the list]
Streptokinase has fibrinolytic activity due to its ability to interact with blood plasminogen. Streptokinase complex with plasminogen possesses proteolytic activity and catalyzes the conversion of plasminogen to plasmin. The latter can cause lysis of fibrin in blood clots; inactivate fibrinogen, as well as blood coagulation factors V and VII.
Streptokinase activity is determined by the ability of a drug to lyse a fibrin clot formed by a mixture of fibrinogen and thrombin solutions under certain conditions and is expressed in international (international) units (IE, 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 the blood clot (especially with fresh blood clots).
Indications for use of streptokinase (avelysin and other drugs) are pulmonary embolism and its branches, thrombosis and embolism of peripheral arteries, superficial and deep vein thrombosis (limbs, pelvis), acute myocardial infarction (during the first 12 hours), retinal sheath thrombosis eyes and other conditions occurring with acute emboli and thrombosis or with the threat of blood clots.
Streptokinase is administered intravenously, and, if necessary, intraarterially.
An intravenous dose is usually administered at a starting dose of 250,000 IU (IE) in 50 ml of isotonic sodium chloride solution for 30 minutes (30 drops per minute). This dose usually causes the onset of clot lysis. Then continue the introduction of streptokinase at a dose of 100,000 IU per hour. The total duration of administration is, as a rule, 16 to 18 hours. Subsequent treatment is carried out with heparin and indirect anticoagulants.
With extensive arterial and venous thrombosis, long-term administration of streptokinase is sometimes necessary.
Intra-arterial injection of streptokinase is used in the acute period of myocardial infarction (initial dose of 20,000 IU; supporting - 2,000–4,000 IU per minute for 30–90 minutes).
In all cases, the introduction of streptokinase should begin as early as possible, since the best effect is observed with fresh blood clots.
Treatment with streptokinase is carried out under the control of thrombin time and blood levels of fibrinogen.
When using streptokinase, nonspecific reactions to protein can develop: headache, nausea, mild chills, allergic reactions (use of corticosteroids is recommended for pronounced allergic reactions).