STREPTOKINAZA (Streptokinase) *.

     Enzyme preparation derived from the culture of b-haemolytic streptococcus Group C.

     Available abroad under the title "Avelizin" (A welysin) [name drug company A WD (A rzneimittelwerk Dresden GmbH Germany), "Streptaza (Streptase)," Kabikinaza (Ka) [bikinase Vypuskavshiysya earlier streptoliaza domestic product dropped from the nomenclature].

     Streptokinase has fibrinoliticheskoy activity because of its ability to interact with plazminogenom blood. Set streptokinase with plazminogenom has proteolytic activity and catalyzes the transformation of plasminogen in plazmin. The latter can cause lysis of fibrin clots in the blood; Inaktivirovat fibrin, as well as V and VII of blood clotting.

     Streptokinase activity determined by the ability to assess drugs under certain conditions fibrin clot formed mixtures and solutions fibrinogena trombina and expressed in international units (international) (IE, or ME).

     Streptokinase applied for the restoration of road trombirovannyh blood vessels; Preparation is lysis phlebo, acting not only from the surface but also penetrate into blood (especially when fresh phlebo).

     Testimony to use streptokinase (avelizina and other drugs) were pulmonary embolism and its branches, thrombosis and embolism peripheral artery thrombosis surface and deep vein (limbs, pelvis), acute myocardial infarction (during the first 12 h), vascular thrombosis mesh shell eye and other conditions occur with acute thrombosis and embolism, or the threat obrazovannya phlebo.

     Enter drip intravenous streptokinase, and if necessary vnutriarterialno.

     Intravenous impose usually in a dose of 250,000 IU (IE) in 50 ml isotonic sodium chloride solution for 30 minutes (30 drops per minute). This dose is usually initiated blood clot lysis. Then continue to introduce streptokinase dose 100000 IU per hour. The total duration of the introduction is usually 16 to 18 hours Subsequent treatment for heparin and anti indirect action.

     With extensive arterial and venous thrombosis sometimes be a lengthy introduction streptokinase.

     Vnutriarterialnoe streptokinase used in a period of acute myocardial infarction (initial dose of 20,000 IU; Supporting - 2000-4000 IU per minute for 30-90 min).

     In all cases, the introduction of streptokinase should begin as soon as possible, as the best effects in fresh phlebo.

     Treatment streptokinase to control trombinovogo time and content in the blood fibrinogena.

     When using streptokinase are the nonspecific reaction to the protein : headache, nausea, light shivers, allergic reaction (expressed in allergic reactions to the use of corticosteroid). With the rapid development of intravenously possible hypotension, cardiac rhythm violation. It should be borne in mind that there might be emboly (for the mobilization of blood clot).

     The drug is contraindicated in acute krovotecheniyah, haemorrhagic diathesis, fresh gastrointestinal ulcers, after recent surgery, and expressed hypertension, septic endocarditis, violations of cerebral circulation, tuberculosis light (kavernoznye forms), in the first trimester of pregnancy.

     Anticoagulants increase protivosvertyvayuschee of streptokinase and increase the risk of bleeding. If immediately before treatment streptokinase patients received heparin, it neutralized the introduction Protamine sulfate (see). In the case of pre-treatment proximity anti encourages the use of drugs in Smolensk K (see); Before treatment streptokinase determine protrombinovoe time.

     Method of issuance : avelizin in dried form in vials containing 100000; 250,000; 750000 1500000 IE or streptokinase. Dissolve just before use.

     In the same package (in different doses) produced other drugs streptokinase.

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     Abroad, was also issued fibrinolitichesky drug urokinaza (Urokinase), activating plazminogen and makes it a plazmin. Get urokinazu of human kidney cell cultures.

     Applied urokinazu mainly on the same grounds as streptokinase, mainly in poor Portability streptokinase (allergic reaction).

     Enter intravenous drip. Usually beginning with the 4400 IE per 1 kg of body weight for 10 minutes, then for 4400 IE / kg per hour for 12 hours Then using heparin or oral anticoagulants.

     Product : in vials of dried powder of 5000 and 250000 IE. Dissolve urokinazu in isotonic sodium chloride solution, or 5% glucose solution.

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