Thrombolysis

Thrombolytic drugs activate plasminogen to form plasmin. This in turn degrades fibrin and help breaks up thrombi. They in primarily used in patients who present with a ST elevation myocardial infarction. Other indications include acute ischaemic stroke and pulmonary embolism, although strict inclusion criteria apply.

Examples

• alteplase
• tenecteplase
• streptokinase

Contraindications to thrombolysis

• active internal bleeding
• recent haemorrhage, trauma or surgery (including dental extraction)
• coagulation and bleeding disorders
• intracranial neoplasm
• stroke < 3 months
• aortic dissection
• recent head injury
• severe hypertension

Side-effects

• haemorrhage
• hypotension - more common with streptokinase
• allergic reactions may occur with streptokinase