7349093
Description
Flashcards by Andrew Street, updated more than 1 year ago
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Created by Andrew Street
almost 8 years ago
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| Question | Answer |
| Give eg's of & indications for fibrinolytic drugs. | eg's: alteplase, streptokinase Indications: • Acute ischaemic stroke - alteplase improves prognosis if given within 4.5/24 of onset • Acute ST elevation MI - alteplase & streptokinase can reduce mortality when they are given within 12/24 of the onset of Sx in combination with antiplatelet agents & anticoagulants. However PPCI has largely superseded fibrinolytics in this. • Reduction of clot size & pulmonary pressures in massive PE with haemodynamic instability |
| MOA of fibrinolytic drugs. | Fibrinolytic drugs, also known as thrombolytic drugs, catalyse the conversion of plasminogen to plasmin, which acts to dissolve fibrinous clots & re-canalise occluded vessels. This allows reperfusion of affected tissue, preventing or limiting tissue infarction & cell death & improving pt outcomes. |
| SE's of fibrinolytic drugs. | • Nausea • Vomiting • Bruising around the injection site If the following SE's occur Rx must be stopped: • Serious bleeding • Allergic reaction • Cardiogenic shock • Cardiac arrest Reperfusion of infarcted brain or HT can lead to: • Cerebral oedema • Arrhythmias |
| CI's, cautions, & important interactions of fibrinolytic drugs. | CI's: • Pt's at risk of bleeding - eg recent haemorrhage, recent trauma or surgery, bleeding disorders, severe HT, peptic ulcers • Following an acute stroke, intercranial haemorrhage must be excluded with a CT scan • Previous streptokinase Rx Cautions: • None Important interactions: The risk of haemorrhage is ^in pt's taking anticoagulants, & antiplatelet agents. ACE inhibitors appear to ^risk of anaphylactoid reactions. |
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