Archive for the 'Thrombolytic Therapy' Category

19 Nov

Anticoagulation and Thrombolytic Therapy: Conclusion

An additional promising approach is the use of synergistic combinations of thrombolytic agents with different mechanisms of fibrin specificity.82 The use of rtPA and SC UPA in a significantly reduced dose combination in patients with coronary artery occlusion produced rapid and effective reperfusion, without evidence of systemic fibrinolytic activation or clinically important bleeding. Since there […]

18 Nov

Anticoagulation and Thrombolytic Therapy: Outcome

Laboratory monitoring during the administration of thrombolytic therapy is intended to document the production of a lytic state. In this regard, the thrombin time and the fibrinogen concentration are the most readily available, the least expensive, and the least labor intensive. Thrombin time prolongations may be exaggerated with concomitant heparinization. The PT and PTT are […]

17 Nov

Anticoagulation and Thrombolytic Therapy: rtPA

Originally isolated from human melanoma cell lines, rtPA has recently become the best characterized and most widely administered fibrinolytic agent produced through recombinant DNA technology. rtPA represents the first major advance in thrombolytic therapy since the introduction of streptokinase and urokinase into clinical medicine. Clinical studies with rtPA have revealed a high degree of safety […]

16 Nov

Anticoagulation and Thrombolytic Therapy: APS AC

The chemical acylation of the catalytic center of purified plasminogen streptokinase activator complexes has resulted in APS AC, a thrombolytic agent that is theoretically more fibrin specific than streptokinase, since physiologic deacy-lation leading to plasmin generation should occur over a time long enough for the inert complex to bind to the thrombus. Plasmin generation within […]

15 Nov

Anticoagulation and Thrombolytic Therapy: Plasminogen activators

Plasminogen activators can be physiologic or pharmacologic. Activated factor Xlla activates plasminogen in vitro; however, its physiologic importance in vivo is unclear. Interestingly, the propositus for severe factor XII deficiency (Hageman) experienced recurrent pulmonary emboli; numerous thrombotic episodes have since been described in others with the same deficiency. Tissue-type plasminogen activator (tPA), which is synthesized, […]

14 Nov

Anticoagulation and Thrombolytic Therapy: The Fibrinolytic Pathway

Other less common complications of warfarin therapy include the “purple toe” syndrome associated with longterm use, alopecia, dermatitis, urticaria, and erythema. “Purple toe” syndrome consists of the rare onset of painful blue discoloration and tenderness of the toes, which occurs predominantly in males after 3-8 weeks of oral anticoagulation therapy. The discoloration persists indefinitely, and […]

13 Nov

Anticoagulation and Thrombolytic Therapy: Drug interactions

The thromboplastin reagents used in the PT assay are derived from either human or rabbit brain. The rabbit brain thromboplastin, popularized in the United States, is less sensitive to changes in vitamin K-dependent factor activity than the human brain thromboplastin standardized in the United Kingdom. Therefore, the results of these two reagents are not equivalent, […]

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