The half-life after intravenous injection of 1500000 IU streptokinase – 1 hour, streptokinase-plasminogen complex – about 23 minutes. Biotransformed in the liver by hydrolysis. It is displayed in a small amount of the kidneys. In diseases of the liver is slowed down clearance, renal insufficiency does not affect clearance.
Indications for use of streptokinase are: propionate testosterone pulmonary embolism and its branches, thrombosis and embolism, peripheral arterial thrombosis of superficial and deep veins (legs, pelvis), acute myocardial infarction (during the first 12 hours), thrombosis, vascular retinal and other conditions, proceeding with acute thrombosis or embolism, and the threat of blood clots.
Dosing and dosing regimen
Enter streptokinase intravenously, and in necessary cases – intra.
Usually administered intravenously in an initial dose of 250,000 IU in 50 ml isotonic sodium chloride solution for 30 min (30 drops per minute). The dose is usually the beginning of a blood clot lysis. Streptokinase administration was then continued per hour. The total duration of administration is usually 16-18 hours. The subsequent treatment is carried out with heparin and indirect anticoagulants.
With extensive arterial and venous thrombosis sometimes need long-term administration of the drug.
Intra-arterial administration of streptokinase is used in acute myocardial infarction (initial dose of 20,000 IU; maintenance – 2000-4000 IU per minute for 30-90 minutes).
In all cases, the introduction of streptokinase propionate testosterone should be initiated as early as possible, as the best effect is observed in fresh thrombi.
streptokinase treatment is carried out under the control of the thrombin time and fibrinogen content of the blood.
When using streptokinase can develop non-specific reactions to the protein: headache, nausea, vomiting, allergic reactions (use of corticosteroids is recommended when expressed allergic reactions).
With rapid intravenous possible development of hypotension, heart rhythm disturbances. Keep in mind the possibility of emboli (due to the mobilization of the elements of the thrombus).
The drug is contraindicated in acute bleeding, hemorrhagic diathesis, fresh ulcers of the gastrointestinal tract, after recent surgery, and severe hypertension, bacterial endocarditis, cerebral circulatory disorders, pulmonary tuberculosis (cavernous forms), in the first trimester of pregnancy.
Symptoms: increased side effects (most often – hemorrhage)
Treatment: haemorrhage (if available), purpose of antifibrinolytic agents (tranexamic acid paraaminometilbenzoynaya acid, or kallikrein protease inhibitors, including aprotinin, aminocaproic acid – 5 g / h, followed by 1 g / hr for 4-8 hours to achieve the effect), replacement of blood loss (except dextran and hydroxyethyl starch), symptomatic treatment.
Treatment is carried out under the supervision of indicators thrombin or partial thromboplastin time. With extreme caution is used when expressed violations of liver and kidney function, diabetes, asthma, streptococcal infections, including rheumatism, bronchiectasis with hemoptysis, varicose veins of the esophagus, the recent appointment of anticoagulants, states after cardiopulmonary resuscitation, mechanical ventilation, bleeding accompanying urological diseases, including urolithiasis, as well as chronic diseases of the gastrointestinal tract, menorrhagia, menstrual bleeding, earlier (from 5 days to 1 year) conducted a course of treatment with streptokinase in old age (over 75 years).
The drug is used in a hospital environment.
Do not use the system in myocardial propionate testosterone infarction after 24 hours or more, deep vein thrombosis – 14 days or more, thrombosis of retinal vessels: arterial occlusions – 6-8 hours or more, venous – 10 days or more, chronic occlusions of the arteries including obliterating endarteritis – 6 weeks or more. online anabolic steroids pharmacy
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