Included in the formulation
АТХ:B.01.A.D. Enzyme preparations
B.01.A.D.01 Streptokinase
Pharmacodynamics:A highly purified protein preparation (enzyme), obtained from the culture of β-hemolytic streptococcus group C. When combined with profibrinolysin (plasminogen) forms a complex that activates its transition in the blood or blood clot into fibrinolysin (plasmin) - a proteolytic enzyme that dissolves fibrin fibers in blood clots and thrombi, causing degradation of fibrinogen and other plasma proteins, including coagulation factors V and VII. Dissolves thrombi, acting both on their surface and from the inside. Has antigenic properties.
Pharmacokinetics:Introduced intravenously drip. The therapeutic effect develops 45 minutes after the start of the treatment. Biotransformation in the liver.
The half-life period is 1 hour, the complex of stektokinase-plasminogen is 23 minutes. Pathways of excretion have not been studied.
Indications:Introduced intravenously drip with thrombosis of deep, pulmonary embolism, acute myocardial infarction due to coronary thrombosis (in the first 3-6 hours), thrombosis of the vessels of the retina.
VII.H30-H36.H34.8 Other retinal vascular occlusions
IX.I20-I25.I21 Acute myocardial infarction
IX.I26-I28.I26 Pulmonary embolism
IX.I70-I79.I74 Embolism and thrombosis of the arteries
IX.I80-I89.I82 Embolism and thrombosis of other veins
Contraindications:Bleeding, hemorrhagic vasculitis, arterial hypertension (at systolic pressure over 200 mm Hg), within 3 months after a hemorrhagic stroke, acute pancreatitis, active form of tuberculosis, sepsis, individual intolerance.
Carefully:Renal and hepatic insufficiency, the elderly age is over 75 years.
Pregnancy and lactation:Recommendations for FDA - Category C. It is used for life indications after 18 weeks of pregnancy and during lactation.
Dosing and Administration:Use in children
1 month to 12 years 2500-4000 ME / kg intravenously drip for 30 minutes.
Adults
Intracoronary (intraarterially) to 20 thousand IU, followed by 2-4 thousand MI / min for 1 hour.
Intravenous drip on 150 thousand IU for 1 hour.
The highest daily dose: 180 thousand.
The highest single dose: 80 thousand IU.
Side effects:Blood coagulation system: hemorrhages in the peri-and myocardium, hematoma, bleeding at the injection sites, internal bleeding.
Cardiovascular system: thromboembolism due to thrombus fragmentation.
Reproductive system: violation of the menstrual cycle.
Allergic reactions.
Overdose:Massive hemorrhage.
Treatment is symptomatic.
Interaction:Simultaneous use with drugs that affect the blood clotting system (anticoagulants, heparin, antiaggregants) increases the risk of bleeding.
Special instructions:Circulating antibodies to streptococci in the blood can inactivate streptokinase and reduce the effectiveness of treatment.
The use of heparin after the administration of streptokinase is possible no earlier than 4 hours later.