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Streptase

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Generic Name: Streptokinase
Product Name: Streptase

Indication

Streptase is used for the treatment of heart attacks (myocardial infarction), and blood clots in the legs (deep vein thrombosis), lungs (pulmonary embolism) or arteries.

Action

Streptase (streptokinase) thins the blood by working with a natural compound in the body (plasminogen) to increase the breakdown of blood clots. This is helpful for treating blood clots, but also means that abnormal bleeding is more likely to occur.

Dose advice

Myocardial infarction:

  • IV administration.
  • Initial dose: 1.5 x 106 IU over 30-60 minutes. Aspirin may be co-administered.
  • Maintenance dose: If reocclusion occurs in Long term anticoagulant therapy. Intracoronary infusion. Initial dose: 20,000 IU bolus (up to 200,000 IU has been given as an initial bolus). Maintenance dose: 2000-4000 IU/minute for 30-90 minutes

Long term lysis- Pulmonary embolism, Deep vein thrombosis, arterial thrombus or embolism:

  • Initial dose: 250,000 IU infused into a peripheral vein over 30 minutes. If thrombin time or other lysis parameters are >1.5 times normal values 4 hours after commencing treatment, discontinue streptokinase, as excessive resistance is present.
  • Maintenance dose: 100,00 IU/hr for 24-120 hrs.
  • Long term control: PTT should be tested from the 16th hr after commencing infusion. PTT of 2-4 indicates adequate anticoagulation protection. If PTT is 2-4 times normal, double Streptase dose for several hours. If PTT tends towards normal values, give Heparin 500-800 IU/hr simultaneously with Streptase maintenance dose, continue Heparin until PTT is within normal limits.

Arteriovenous cannula occlusion:

  • Before using streptokinase attempt to clear the cannula using heparinized saline.
  • If this fails, slowly instill streptokinase 250,000 IU in 2mL solution into each occluded limb of the cannula.
  • Clamp off the cannular limb(s) for two hours, observing the patient for adverse effects.
  • After treatment aspirate contents of infused cannula limb(s), flush with saline, reconnect cannula.

Other intra-arterial application:


  • Initial dose: 1000-2000 IU at 3-5 minute intervals for up to 3 hours.
  • Long term: Heparin treatment is recommended after streptokinase therapy to prevent rethrombosis.

Schedule

S4

Common side effects

  • Bleeding incidence and severity varies according to dosage, patient population and concomitant therapy.
  • Minor bleeding can be anticipated at invaded or disturbed sites. Menstrual bleeding may be aggravated.
  • Fever.

Uncommon side effects

  • Mild reactions such as urticaria, rash, itching, flushing, nausea, headache, musculoskeletal pain and delayed hypersensitivity reactions (e.g. arthritis, arthralgia, vasculitis, interstitial nephritis) have also been observed.
  • Headache, back or muscle pain, gastrointestinal complaints, malaise, chills, transient increases in serum transaminase and/or bilirubin, tachy- or bradycardias (fast or slow heart rates), hypotension (low blood pressure), neuroallergic (e.g. polyneuropathy) symptoms, pulmonary embolism. Very rare: uveitis, renal insufficiency, cholesterol embolism, cardiac rhythm disturbances, angina, cardiac failure and arrest.

For further information talk to your doctor.


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Dates

Posted On: 22 July, 2003
Modified On: 13 May, 2016


Created by: myVMC