The Brand Name NISKINASE Has Generic Salt :: Streptokinase
NISKINASE Is From Company NEISS Priced :: Rs. 1650.00/2750.00
NISKINASE have Streptokinase is comes under Sub class Thrombolytics of Main Class Hematological System
Main Medicine Class:: Hematological System Sub Medicine Class :: Thrombolytics
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Indications for Drugs ::
Acute Evolving Myocardial Infarction, Acute Massive Pulmonary Embolism, Deep Vein Thrombosis, Arterial Thrombosis or Embolism, Arteriovenous Cannulae Occlusion.
Drug Dose ::
Adult: IV infusion: Acute MI: 1.5 million u as a single dose immediately after onset of symptoms. Total solution volume 45 ml. Infusion rate: Infuse 45 ml within 60 mins. Pulmonary thromboembolism; Deep Vein Thrombosis, Arteriovenous occlusions Loading dose: 250,000 u via infusion. Total solution volume 90 ml, Infusion rate: Infuse 30 ml/hour for 30 min. Maintenance: 100,000 u/hr for 24-72 hr depending on the condition treated. Duration for cerebral retinal thrombosis: 12 hr. Maintain thrombin clotting time at 2-4 times normal values. Child: Loading dose: 2500-4000 units/kg over 30 min, followed by infusion of 500-1000 units/kg/hr, continued until reperfusion occurs, up to 3 days. Initial dose may be estimated by streptokinase resistance test. Monitor treatment by maintaining thrombin clotting time at 2-4 times normal values.
Severe hypertension, recent stroke, cerebral neoplasm, recent history of peptic ulcer disease, ulcerative colitis, pancreatitis, subacute bacterial endocarditis, coagulation defects also due to liver or kidney disease, recent surgery, childbirth. Hypersensitivity, increased risk of cerebral bleeding, trauma. Pregnancy. Active internal bleeding, bleeding GI lesions. Arteriovenous malformation or aneurysm; recent (within 10 days) facial or head trauma, intracranial or intraspinal surgery, More than 5 days and less than 12 months since previous Streptokinase therapy.
Drug Precautions ::
Mitral stenosis associated with AF. Streptokinase treatment within last 12 mth, use after prolonged or traumatic CPR; diabetic retinopathy. Elderly. Because of the increased likelihood of resistance, due to antistreptokinase antibodies, retreatment with Streptokinase or Streptokinase-containing products may not be effective if administered between five days and twelve months of prior Streptokinase administration or Streptococcal infections, such as Streptococcal pharyngitis, acute rheumatic fever or acute glomerulonephritis secondary to a Streptococcal infection. In principle, no thrombolytic treatment should be commenced before the 10th postoperative day. However, in cases of pulmonary embolism, the indication for earlier treatment may be very strong and after careful consideration of all the risks, Streptokinase may be given before the tenth postoperative day. The danger of bleeding from the operative area must, of course, be taken into account. The danger of haemorrhage is increased by simultaneous or previous treatment with anticoagulants (e.g., Heparin) or substances which inhibit platelet formation or function. If the patient is under active heparinisation, it should be neutralised by the administration of protamine sulphate before the start of thrombolytic therapy. Repeated Administration After administration of Streptokinase, the titre of antistreptokinase antibodies begins to rise after approximately one week, reaching a peak at 2 to 3 weeks and remains elevated for 8 to 12 months. Because of the increased likelihood of resistance, Streptokinase may not be effective if given during this period.
Drug Side Effects ::
Headache and back pain, muscle pain (including myalgia), chills and/or fever as well as asthenia/malaise. Gastrointestinal or genitourinary bleedings (including aggravation of menstrual bleeding), epistaxis. Development of antistreptokinase antibodies. Hypotension, heart rate and rhythm disorders, angina pectoris. Recurrent ischaemia, heart failure, reinfarction, cardiogenic shock, pericarditis, pulmonary oedema. Nausea, diarrhoea, epigastric pain and vomiting. Arrhythmia, bruising, rash, pruritus, acute renal failure due to embolism and haemorrhage. Cerebral, peripheral and pulmonary embolism. Allergic reactions, liver enzyme abnormalities, hypotension. Potentially Fatal: Haemorrhage; anaphylactic shock.
Pregnancy category ::
Drug Mode of Action ::
Streptokinase forms a complex with plasminogen which then converts plasminogen to plasmin. Plasmin breaks down clots as well as fibrinogen and other plasma proteins.
Drug Interactions ::
Antagonistic effects with antifibrinolytic agents e.g. aminocaproic acid. Potentially Fatal: Anticoagulants, heparin, antiplatelet agents e.g. aspirin and dipyridamole affect platelet function increasing the risk of haemorrhage.