Streptokinase is an enzyme that helps dissolve blood clots and has been widely used in medical conditions. It was first discovered from bacteria called beta-hemolytic streptococci and has a history of clinical use since the mid-20th century. Streptokinase is crucial in treating cardiovascular conditions and is vital in reducing the complications and deaths associated with thromboembolic disorders.
II. Composition of Streptokinase
The main. The molecule's structure consists of a polypeptide chain of 414 amino acids. There is a domain that is bound together without the need for covalent bonds, and it exhibits stability at neutral pH levels. When it comes to manufacturing, Streptokinase is primarily synthesized using DNA technology. This process involves inserting plasmids into host cells to enable large-scale production. Pharmaceutical companies implement stringent quality control measures to ensure the purity and effectiveness of their products. These measures include utilizing High-Performance Liquid Chromatography (HPLC) and electrophoretic methods.
III. How Streptokinase Works
How Streptokinase works by activating the conversion of plasminogen into plasmin. This process helps in dissolving fibrin clots. When administered, it forms a complex with plasminogen and brings about changes that speed up the enzymatic conversion to plasmin. The therapeutic benefits of Streptokinase include enhancing blood flow, restoring tissue perfusion, and preventing necrosis in areas.
IV. Uses of Streptokinase
Streptokinase is a thrombolytic medication that activates plasminogen by nonenzymatic mechanism 1. It is FDA-approved for treating acute ST-segment elevation myocardial infarction, arterial thrombosis or embolism, deep vein thrombosis, pulmonary embolism, and arteriovenous cannula occlusion 2. The following are the approved uses of Streptokinase:
- Treatment of Acute Myocardial Infarction: Streptokinase has been proven to be highly effective in restoring blood flow to the heart and limiting the size of a heart attack 3.
- Deep Vein Thrombosis: It is used to help reopen blocked veins and restore blood flow 3.
- Pulmonary Embolism: This treatment is essential in managing cases of pulmonary embolism 3.
The following are the off-label uses of Streptokinase:
- Peripheral Vascular Disease: Although not officially approved for this use, it is sometimes used to improve blood flow in limbs affected by blood supply 3.
- Stroke: In cases of acute ischemic stroke, this medication may be cautiously used under careful consideration 3.
- Infertility Treatments: It can be administered to enhance blood flow during certain infertility treatments 3.
V. Dosage and Administration
a. Standard Dosages for Heart Attack Typically, a standard dosage of around 1.5 million IU is administered over 60 minutes. For Pulmonary Embolism, The recommended dose is usually 250,000 IU given over 30 minutes, followed by a maintenance dose of 100,000 IU per hour. b. Administration Procedures Intravenous Infusion: It is preferable to administer the medication in acute heart attack cases. Intracoronary Route: This method can directly deliver medicine into the artery. c. Tips for Healthcare Providers It's essential for healthcare providers to closely monitor the patient's hemodynamics during administration to anticipate any complications. Minor Side Effects Some common but not exhaustive minor side effects may include nausea, mild hypotension ( blood pressure), and fever. Moderate Side Effects In cases, patients may experience abnormalities in their blood composition, like temporary low platelet count (thrombocytopenia). d. Rare But Serious Side Effects Anaphylactic Reactions Although rare, anaphylaxis is an allergic reaction that requires immediate medical attention and intervention. Hemorrhage (Bleeding) Serious bleeding complications, including hemorrhage (bleeding within the skull), necessitate an immediate halt in therapy. Allergic Reactions Rare but possible allergic reactions may manifest as hives (urticaria) or bronchospasm (constriction of airways).
VI. Drug Interactions
Medications That Can Interact with Streptokinase When taking Streptokinase, it's essential to be aware of medications that may impact its effectiveness and safety. Some key medicines that can interact with Streptokinase include; Anticoagulants like Warfarin, Antiplatelet agents such as Aspirin Nonsteroidal AntiInflammatory Drugs (NSAIDs) Things to Avoid While Taking Streptokinase While undergoing Streptokinase therapy, it is advisable to steer clear of certain substances, including; Alcohol; It can increase the risk of bleeding. Supplements like Ginkgo Biloba can potentially heighten the risk of bleeding. Remember to consult your healthcare provider, for information and guidance related to your specific situation.
VII. Warnings and Precautions
a. Important Precautions and Monitoring Requirements: Regularly monitoring platelet count and coagulation profiles is necessary. It cannot be neglected. It is essential to be vigilant for any bleeding complications due to the nature of the treatment. b. Contraindications: Any underlying tendency towards diathesis is an absolute contraindication for this treatment. Patients who have recently undergone surgery or experienced trauma are generally not eligible for Streptokinase. c. Careful Administration: It is crucial to administer the medication by adjusting the dosage as needed and closely monitoring hemodynamic indicators throughout the process.
VIII. Special Populations
a. Dosage Adjustments for the Elderly When it comes to the population, it is often necessary to take a more cautious approach and adjust the dosage accordingly. It is crucial to monitor their renal function and cardiovascular status. b. Considerations for Pregnant Women and Nursing Mothers Before administering medication to women and nursing mothers, it is essential to thoroughly evaluate the balance between risks and benefits. Due to limited data, healthcare professionals should exercise conservative clinical judgment. c. Administering Medication to Children Determining dosages for children can be challenging as well-established guidelines still exist. Therefore, it is crucial to approach dosing cautiously and prioritize safety measures without comprehensive studies.
IX. Overdose and its Management
Signs and symptoms of an overdose often involve bleeding complications and low blood pressure. Taking action to stop the drug and providing supportive measures to stabilize blood flow is crucial in managing an overdose situation.
X. Storage and Handling Precautions
For storage, it is recommended to keep Streptokinase at a temperature between 2 8°C. It's important to avoid sunlight exposure. When stored under the recommended conditions, Streptokinase maintains its effectiveness for 24 months. To dispose of used vials, please follow the protocols for biomedical waste management as per your local guidelines.