Description of the medicine: Streptokinase (Streptokinase)
Streptokinase (Streptokinase) *.
An enzyme preparation obtained from a culture of b-hemolytic streptococcus group C.
It is produced abroad under the names "Avelizin" (Аwelysin) "[The name of the drug is AWD (Аrzneimittelwerk Dresden GmbH Germany)]," Streptase "(Streptase)," Cabikinase "(Kabikinase) [The previously produced domestic preparation of streptoliasis is excluded from the nomenclature].
Streptokinase has fibrinolytic activity, due to its ability to interact with blood plasminogen. The streptokinase complex with plasminogen has proteolytic activity and catalyzes the conversion of plasminogen to plasmin. The latter can cause fibrin lysis in blood clots; inactivate fibrinogen, as well as factors V and VII of blood coagulation.
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 expressed in international (international) units (IE, or ME).
Apply streptokinase to restore 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 the use of streptokinase (avelizin and other drugs) are embolism of the pulmonary artery and its branches, thrombosis and embolism of peripheral arteries, thrombosis of the superficial and deep veins (limbs, pelvis), acute myocardial infarction (within the first 12 hours), retinal vascular thrombosis eyes and other conditions occurring with acute embolism and thrombosis or with the threat of blood clots.
Streptokinase is administered intravenously, and, if necessary, intra-arterially.
250,000 IU (IE) is usually administered intravenously in 50 ml of an isotonic sodium chloride solution for 30 minutes (30 drops per minute). This dose usually causes the onset of thrombus lysis. Then continue the administration of streptokinase at a dose of 100,000 IU per hour. The total duration of administration is usually 16 to 18 hours. Subsequent treatment is carried out with heparin and indirect anticoagulants.
With extensive arterial and venous thrombosis, prolonged administration of streptokinase is sometimes necessary.
Intraarterial administration of streptokinase is used in the acute period of myocardial infarction (initial dose of 20,000 IU; maintenance dose - 2,000 - 4,000 IU per minute for 30 - 90 minutes).
In all cases, the administration of streptokinase should be started 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 the content of fibrinogen in the blood.
When using streptokinase, nonspecific reactions to the protein may develop: headache, nausea, slight chills, allergic reactions (with severe allergic reactions, the use of corticosteroids is recommended).