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Streptokinase is a thrombolytic medication activating plasminogen by nonenzymatic mechanism. [1] As a medication it is used to break down clots in some cases of myocardial infarction (heart attack), pulmonary embolism, and arterial thromboembolism. [2] The type of heart attack it is used in is an ST elevation myocardial infarction (STEMI). [3]
However, streptokinase causes systemic fibrinolytic state and can lead to bleeding problems. Tissue plasminogen activator (tPA) is a different enzyme that promotes the degradation of fibrin in clots but not free fibrinogen. [14] This drug is made by transgenic bacteria and converts plasminogen into the clot-dissolving enzyme, plasmin. [15]
A stroke is the rapid decline of brain function due to a disturbance in the supply of blood to the brain. [13] This can be due to ischemia, thrombus, embolus (a lodged particle) or hemorrhage (a bleed). [13] In thrombotic stroke, a thrombus (blood clot) usually forms around atherosclerotic plaques. Since blockage of the artery is gradual, the ...
Symptoms. Atherosclerosis is often referred to as a silent killer, since symptoms often don’t appear or are minimal until it causes severe cardiovascular disease or other complications.
Pulmonary embolism (blood clots that have moved to the lung arteries) is usually treated with heparin generally followed by warfarin. If pulmonary embolism causes severe instability due to high pressure on the heart ("massive PE") and leads to low blood pressure, recombinant tPA is recommended. [22] [23] [24]
Hemorrhagic stroke is a rare but serious complication of thrombolytic therapy. If a patient has had thrombolysis before, an allergy against the thrombolytic drug may have developed (especially after streptokinase). If the symptoms are mild, the infusion is stopped and the patient is commenced on an antihistamine before infusion is recommenced.
[3] [6] [7] Because irreversible injury occurs within 2–4 hours of the infarction, there is a limited window of time available for reperfusion to work. [ citation needed ] Thrombolytic drugs are contraindicated for the treatment of unstable angina and NSTEMI [ 3 ] [ 8 ] and for the treatment of individuals with evidence of cardiogenic shock .
Many have symptoms of stroke: inability to move one or more limbs, weakness on one side of the face or difficulty speaking. The neurologic deficits related to central venous thromboses does not necessarily affect one side of the body or one arterial or brain territory as is more common "arterial" strokes.