None of the patients were having cardiogenic shock at the time of presentation when administered streptokinase
. Severity of cardiac dysfunction was similar in both the study and the control group.
Systemic routes of administration of thrombolytic drugs Drug name Loading dose Infusion dose Streptokinase
250000 IU, 30 min 100000 IU/h Urokinase 4400 IU, 10 min 4400 IU/kg/h Alteplase (rt-PA) Not needed 50 mg/h * Reteplase Not needed 10 U IV bolus, twice with 30- min interval Tenecteplase Not needed 10000 U bolus single dose in 5-10 seconds ** Drug name Administration time Streptokinase
24 h Urokinase 12 h Alteplase (rt-PA) 2 h Reteplase Tenecteplase * For patients below 65 kg, total dose in 2 h is calculated as 1.5 mg/kg ** Should be administered based on body weight with maximum dose of 50 mg (10000 U tenecteplase)
Optimization studies for enhanced production of streptokinase
The mortality rate in the group treated with reteplase had 4.5% and group treated with streptokinase
had 5.2% during hospital stay.
Several agents have been administered as fibrinolytic treatment, such as streptokinase
, urokinase, tissue plasminogen activator etc.
Heparin is considered to be effectual and is regularly given as an adjunct for PCI and thrombolytic therapy although it is frequently withheld in the first 24 hours in those patients receiving Streptokinase
. The role of heparin is mainly to decrease reinfarction but the combination of dual antiplatelet therapy, thrombolysis, and heparin may amplify the risk of bleeding.
is the lone nonfibrin-specific thrombolytic agent available in the pharmaceutical market (Vaishnavi et al., 2011).
Pathological development of blood clots requires clinical intervention with fibrinolytic agent such as urokinase, tissue plasminogen activator and streptokinase
Due to frequent hemorrhagic complications streptokinase
, urokinase (UK) and prourokinase (r-proUK) are not preferred (Multicentre Acute Stroke Trial--Italy (Mast-I) Group, 1995; Multicentre Acute Stroke Trial--Europe Study Group, 1996; Yasak, Chambers, Davis, and Donnan, 1998).
The drugs used were streptokinase
(n=6) and rtPA (n=7).
The thrombolytic drugs tested included: alteplase (Cathflo Activase, Genentech, Inc, San Francisco, California), urokinase (Abbokinase, Abbott Laboratories, Abbott Park, Illinois), streptokinase
(Streptase, Aventis, Paris, France), tenecteplase (TNKase, Genentech, Inc), and reteplase (Retavase, Boehringer Mannheim, Mannheim, Germany).