Thrombolytic drugs
Five thrombolytic drugs are currently available in Australia—alteplase, reteplase, tenecteplase, streptokinase and urokinase. They achieve thrombolysis by stimulating the conversion of plasminogen to plasmin, which then causes the breakdown of insoluble fibrin into fibrin degradation products. The consequences of enhanced fibrinolysis include dissipation of pathological thrombus, and an increased risk of haemorrhage. Increased bleeding can occur at injection sites, into the gastrointestinal and genitourinary systems, and intracerebrally. The fibrinolytic effects are dose-related. Allergic reactions including fever, chills, bronchospasm, hypotension and anaphylactoid reactions can also occur, particularly with streptokinase.
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