Generic Name : Streptokinase.

Trade Name    : Streptase, Kabikinase, Streptocinase.

Drug Class     : Thrombolytic class.

Forms of The Drug

  1. Lyophilized Powder for Injection (IV).

Mechanism Of Action

Its mechanism of action involves its ability to activate the body’s natural clot-dissolving system, known as the fibrinolytic system. Here’s an overview of how streptokinase works:

  1. Plasminogen Activation: Streptokinase functions by binding to and activating the inactive precursor molecule called plasminogen. Plasminogen is naturally present in the blood and is converted to its active form, plasmin, through various activators.
  2. Conversion to Plasmin: Once bound to streptokinase, plasminogen undergoes a conformational change, becoming enzymatically active plasmin. Plasmin is a proteolytic enzyme that breaks down fibrin, the primary protein in blood clots, into smaller fragments called fibrin degradation products.
  3. Fibrinolysis: Plasmin’s primary role is to digest the fibrin meshwork within blood clots. By breaking down the fibrin strands, plasmin dissolves the blood clot, allowing for its gradual breakdown and clearance from the bloodstream.
  4. Clot Dissolution: The process of fibrinolysis initiated by streptokinase-mediated plasminogen activation leads to the dissolution of the blood clot, restoring blood flow in affected arteries or veins.
  5. Systemic Effects: Streptokinase exerts its effects systemically, meaning it acts throughout the bloodstream, not specifically targeting one clot but affecting clots in various parts of the body.

Indications

  1. Acute Myocardial Infarction (Heart Attack).
  2. Pulmonary Embolism.
  3. Deep Vein Thrombosis (DVT).
  4. Arterial Clotting Disorders.

Contraindications

  1. Active bleeding, such as gastrointestinal bleeding, intracranial bleeding (hemorrhagic stroke), or other bleeding disorders.
  2. History of Intracranial Hemorrhage.
  3. Severe Hypertension.
  4. Recent Major Surgery or Trauma.
  5. Internal Bleeding Disorders.
  6. Aneurysm or Vascular Malformations.
  7. Recent Traumatic Cardiopulmonary Resuscitation (CPR).
  8. Suspected Endocarditis.

Side Effects

  1. Bleeding.
  2. Allergic Reactions: as hives, itching, rash, or, in severe cases, anaphylaxis.
  3. Fever.
  4. Hypotension.
  5. Nausea and Vomiting.
  6. Bruising or Hematomas.
  7. Reperfusion Arrhythmias.
  8. Hypersensitivity Reactions.

Drug Interactions

Other drugs that can interact with it.

  1. Other Anticoagulants and Antiplatelet Medications: Combining streptokinase with other anticoagulants (such as heparin, warfarin, direct oral anticoagulants) or antiplatelet medications (like aspirin, clopidogrel).
  2. NSAIDs, such as ibuprofen, naproxen, or aspirin.
  3. Thrombolytic Agents: Concomitant use of other thrombolytic agents, such as alteplase or tenecteplase.
  4. Certain Antibiotics and Antifungal Medications: Some antibiotics (e.g., cephalosporins) and antifungal medications (e.g., fluconazole).
  5. Herbal Supplements and Natural Products: Herbal supplements like ginkgo biloba, garlic, or vitamin E.

Precautions

  1. Pregnancy: Category C.
  2. Lactation: There’s limited information available regarding the excretion of Streptokinase into breast milk or its effects on nursing infants. As Streptokinase is administered intravenously and primarily used in emergency situations to dissolve blood clots, its usage during breastfeeding is not common.

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