Medicine an Surgery notes

Apr 25th, 2015
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THROMBOLYTIC THERAPY Intravenous thrombolytic therapy for acute myocardial infarction in the EuropeanCooperative Study Group trial was found to reduce mortality significantly Although the standard of care in areas with adequate facilities and experience inpercutaneous coronary intervention (PCI) now favors catheterization andplacement of a stent, thrombolytic therapy is still very important where PCI is notreadily available. The proper selection of patients for thrombolytic therapy is critical. The diagnosisof acute myocardial infarction is made clinically and is confirmed byelectrocardiography and cardiac enzymes (including Troponin I). Patients with ST-segment elevation and bundle branch block onelectrocardiography have the best outcomes. All trials to date show the greatest benefit for thrombolytic therapy when it isgiven early, within 6 hours after symptomatic onset of acute myocardial infarction. Adjunctive drugs such as aspirin, heparin, -blockers, and angiotensinconverting enzyme (ACE) inhibitors reduce mortality even further.Thrombolytic Agents1) Streptokinase2) Urokinase3) Alteplase4) Reteplase5) Tenecteplase6) Anistreplase7) Tissue plasminogen activators (t-PAs)Pharmacology1)Streptokinase;Streptokinase is a protein (but not an enzyme in itself) synthesized bystreptococci that combines with the proactivator plasminogen. Thisenzymatic complex catalyzes the conversion of inactive plasminogen toactive plasmin

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