FIBRINOLYTICS

&
ANTI-FIBRINOLYTICS
MR. A. M. BELEKAR (M. PHARM. PHARMACEUTICS),
LECTURER (SELECTION GRADE),
KDCA INSTITUTE OF PHARMACY, KOLHAPUR.
FIBRINOLYTICS

• Drugs used to break thrombi or clot to recanalize

occluded blood vessel
• These are mainly curative rather than prophylactic.
• E.g. Streptokinase, Urokinase, Alteplase, Reteplase,
Tenecteplase
STREPTOKINASE
• Obtained from β haemolytic Streptococci
• Inactive as such
• Combines with circulating plasminogen to form an activator complex
• Coplex causes limited proteolysis of other plasminogen molecules to plasmin
• Plasmin converts insoluble fibrin into soluble fibrin fragments
• Thus it breaks clot.
• Antigenic and can cause hypersensitivity reactions and anaphylaxis
• Repeat doses are also less effective due to neutralization by antibodies
• Fever is common, hypotension and arrhythmias are reported.
UROKINASE

• An enzyme isolated from human urine

• Now prepared from cultured human kidney cells
• Activates plasminogen directly and is nonantigenic
• Fever occurs during treatment, but hypotension and
allergic phenomena are rare
USES OF FIBRINOLYTICS

• Acute myocardial infarction

• Deep vein thrombosis
• Pulmonary embolism
• Peripheral arterial occlusion
• Stroke
ANTI-FIBRINOLYTICS

• Drugs which inhibit plasminogen activation and

dissolution of clot
• E.g. Epsilon amino-caproic acid (EACA), Tranexaemic
acid
USES OF ANTI-FIBRINOLYTICS
• Overdose of fibrinolytics
• After cardio-pulmonary bypass surgery
• After tonsillectomy, prostatic surgery, tooth
extraction in haemophiliacs.
• Bleeding peptic ulcer.
• menorrhagia