Article Contents ::
Details About Generic Salt :: Urokinase
Main Medicine Class:: Hematological System Sub Medicine Class :: Thrombolytics
| 5C. THROMBOLYTICS in 5. HEMATOLOGICAL SYSTEM |
| UROKINASE |
| PROTEOLYTIC ENZYME | THROMBOLYTIC |
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Indications & Dose: CLEARING OCCLUDED INTRAVENOUS CATHETER/CANNULA Adult 5000-25000 units of urokinase dissolved in 2 mL of Nacl 0.9% instill into the device & clamped off for up to 4h; the lysate is then aspirated, repeat the procedure if necessary or 5000 units of urokinase in 200 mL of Nacl 0.9% infuse into the device over 30min | PERIPHERAL ARTERIAL THROMBOEMBOLISM IV Adult Solution containing 2000 U/mL given at a rate of 4000U/min 2h. If flow has not resumed continue for further 2h, may repeat up to 4 times, if needed. Once blood flow is re-established, withdraw catheter partially & continue inf (1000U/min) until the remaining clot has lysed | VENOUS THROMBOEMBOLISM IV Adult Initially 4400U/kg over 10 min, followed by 4400U/kg/h for 12h (pulmonary embolism) or 12-24h (DVT) |
| Contra: patients with active internal bleeding/ recent history of PUD, esophageal varices, UC, bleeding GI lesions, pancreatitis, subacute bacterial endocarditis, patients with coagulation defects due to liver/kidney disease, childbirth, trauma, recent surgery, patients at increased risk of cerebral bleeding, severe HTN, hemorrhage, recent stroke, cerebral neoplasm, heavy vaginal bleeding, invasive procedures, IM Inj during & immediately before and after streptokinase therapy, should not be given in the period between 5 days & 12 months after the initial dose
Precautions: patients at increased risk of bleeding, hemorrhage, elderly, mitral stenosis associated with atrial fibrillation ADR: Serious: hemorrhage, severe internal bleeding, anaphylactoid, serum-sickness-like symptoms, guillain-barre syndrome, hypotension, bradycardia, arrhythmias, emboli, pulmonary embolism, ARF due to cholesterol embolization, Others: rashes, fever, chills, nausea, vomiting, back/abdominal pain DDI: Serious Streptokinase causes rigors & bronchospasm (in patients who previously treated with streptokinase) |