Fibrinolytic agents
This information is not intended for purposes of treatment without physician.
Thrombolytic medicines
Thrombolytic (from the Greek. thrombos - the blood clot, lytikos - to dissolve) or fibrinolytic medicines subdivide into the straight fibrinolytic - preparation plasmin, and indirect fibrinolytic - preparations streptokinase, altepmanhole and other
Fibrinolytic means
Fibrinolytic means - this is the group of the medicines, which cause the destruction of the formed threads of fibrin and they contribute to the resolution of fresh (not yet subjected to organization) dust devils.
Classification
Fibrinolytic means are divided into groups of direct and indirect action.
The first group includes the substances, which directly influence the plasma of the blood, the cluster of the threads of fibrin. They are effective in vitro and in vivo. In the second group the activators of fibrinolysis are located. They are inactive under the direct effect on the thread of fibrin, but during the introduction into the organism they activate the endogenous fibrinolytic system of the blood.
Plasmin is the representative of the preparations of the first group. As the activators of fibrinolysis (preparations of the second group) use the preparations of streptokinase (protein from beta-hemolytic streptococcus a) and streptodecasum, and others.
Indirect fibrinolytics, or activators of plasminogen, include preparation streptokinase - fermentation preparation, obtained from culture of the β- hemolytic streptococcus of group C.
At the basis of the thrombolytic action of streptokinase lies the ability of preparation to join to its one molecule one molecule of plasminogen. The formed complex stimulates the passage of plasminogen into plasmin. The latter in contrast to the plasmin possesses the ability to penetrate inside the dust devil and to cause the fragmentation (lysis) of fibrin in the blood clot and to thus achieve recanalization of the scored thrombus vessel. Besides this streptokinase possesses the ability to inactivate fibrinogen, and also factors of coagulation of the blood of the V and VII.
As indications to the clinical application of streptokinase serve sharp myocardial infarction (first 12 hours), thromboembolism of pulmonary artery and its branches, thrombosis of peripheral arteries, thrombosis of deep veins and so forth
The caused by preparation system fibrinolysis can be the reason for heavy system hemorrhages; therefore during the treatment it is necessary to constantly control the fibrinolytic activity of the blood, and also the content in it of fibrinogen.
Is recently in the clinical practice inculcated the preparation of altepmanhole, which is been the woven activator of plasminogen. Preparation is obtained from the culture of the cells of man via genetic engineering.
Indication to the clinical application of preparation is woven plasminogen, directly connected with the fibrin of dust devil; therefore altepmanhole in the considerably smaller degree, than streptokinase, cause system fibrinolysis and predominantly realizes its action locally - both on the surface and inside the dust devil.
In the clinical practice alteplase is used as the thrombolytic medicine into first 6-12 hours from the moment of the development of sharp myocardial infarction, and also with thromboembolism of pulmonary artery.