In the body, various chemical reactions occur continuously. Blood is a specific fluid, which is characterized by certain processes: thrombus formation and liquefaction of clots that have appeared. When the body’s reserves are running out, thrombolytic drugs come to the rescue.
These are medications that are administered intravenously to prevent clotting of blood vessels. Thrombosis can develop in veins or arteries. It impairs the functioning of important organs, and can also cause various complications and even lead to death.
Characteristic
The main goal of thrombolytic drugs is the dissolution of blood clots that interfere with normal microcirculation. Modern medicines help in the most difficult situations.
In most cases, people confuse thrombolytics, anticoagulants and antiplatelet agents with each other. The first group of medicines eliminates an existing blood clot, and the rest prevents its formation. They are used, as a rule, for preventive purposes.
Thrombolytics themselves are enzymes that enter the damaged vessels in liquid form. About an hour after use, the drug is actively acting, which contributes to a quick solution to the problem.
It must be remembered that all thrombolytic drugs are used only for life-threatening conditions of a medical institution and under the supervision of a doctor.
How do thrombolytics work?
When the body does not cope with already formed blood clots, specialized therapeutic agents are used. Fibrin is a protein that is responsible for viscosity. With its deficiency, there is a violation of the process of blood coagulation and bleeding, and with an increased content - blood clots form.
For the breakdown of a fibrin clot, plasmin is required, which constantly moves in the blood, but it may be small. To eliminate a blood clot, an enzymatic solution is injected into a vein, which activates the destruction of fibrin accumulations.
The spectrum of action of thrombolytic drugs is based on a temporary increase in the number of plasmin in the blood. There are several methods of administering the medication:
- Infusion - a slow injection of the drug into a vein.
- Bolus - quick infusion of an impressive dose of a solution for an immediate reaction of the body.
- The mixed method is first a quick injection of the drug, and then a slow injection.
When it is advisable to use thrombolytics
These funds are used in various fields of medicine. As a rule, they are recommended in the treatment of diseases that are associated with high blood clots. Medications are suitable for the treatment of arterial as well as venous and systemic forms of thrombosis.
Indications:
- Ischemic stroke (impaired microcirculation of the brain with impaired tissue).
- Myocardial infarction (one of the forms of cardiac ischemia, which occurs with the onset of ischemic necrosis of a portion of the heart muscles, due to the absolute or relative insufficiency of its microcirculation).
- Thromboembolism of the lungs (clogging of the pulmonary artery or its branches with blood clots, which form more often in the large veins of the lower extremities or pelvis).
- Thrombosis of large vessels (a disease caused by the formation of blood clots on the inner walls of arteries and veins, in which blood clots block the lumen of the vessel and disrupt blood circulation).
- Blood clots in the heart.
What thrombolytic drugs are used for myocardial infarction?
Prohibitions to use
The main disadvantage of thrombolytic drugs is an increased risk of bleeding, which worsen the state of health and can aggravate the course of the disease. Before using medicines, you should be familiar with the recommendations, as they have relative and absolute limitations. Before therapy, the doctor should conduct a blood test and an electrocardiogram, and only then prescribe a medication.
Contraindications:
- Internal bleeding.
- Recently past abdominal surgery.
- Surgery in the spinal cord and brain.
- Hypertension (a disease in which sustained high blood pressure is noted).
- Inflammation in the pericardium (damage to the pericardial sac is more often infectious, rheumatic, or post-infarction).
- Aortic aneurysm (expansion of a limited area of the aortic wall, resembling a spindle shape or a bag-like formation, or a diffuse increase in its lumen by more than 2 times compared with an unchanged area).
- Acute pancreatitis (acute aseptic inflammatory lesion of the pancreas of the demarcation type).
- Insufficient blood coagulability.
- Individual reaction.
- Reception of anticoagulants.
- The acute form of diathesis (the state of the child’s body, which is characterized by a tendency to occur for certain diseases, for example, respiratory infections).
- Diseases that lead to bleeding.
- Changes in the structure of cerebral vessels.
- High blood pressure.
- Diabetic retinal damage.
- Thrombophlebitis (thrombosis with inflammation of the vein wall and the formation of a thrombus that closes its lumen).
- Injuries to the head and spinal column.
- Serious burns.
- Complicated fractures of the limbs.
- Bleeding in the stomach or intestines.
Means of this group are quickly eliminated from the body, therefore poisoning is extremely rare.
Classification of thrombolytic drugs
There are currently five generations of drugs:
- The first generation is enzymes that exist in nature. They transform blood plasma and have a positive effect on accelerating the synthesis of plasmagen into plasmin. Active substances are isolated from the blood. Such medications change coagulation, thereby causing severe bleeding. These substances act as foreign to the body, causing allergic manifestations. They help to get a quick effect, but because of the possibility of severe bleeding, they are rarely used.
- The second generation is fibrin-specific drugs, which were created artificially with the help of E. coli bacteria. They affect mainly blood clots, while there are no adverse reactions. A minimum of flaws makes them more popular nowadays.
- The third generation is recombinant activators. Their advantages are a longer exposure, as well as the ability to find a blood clot.
- The fourth generation is a complex-acting drugs that are quicker and have a greater effect on blood clots compared to drugs of previous generations. Unfortunately, they have not yet been sufficiently studied.
- The fifth generation is a combination of natural and recombinant active ingredients.
First Generation Drug List
List of the most popular medicines:
- Fibrinolysin.
- "Streptokinase."
- Urokinase.
- "Streptodekase."
- Thromboflux.
Fibrinolysin is a natural enzyme that is secreted from donated blood and produced in powder for intravenous injections. It acts on protein (protein) filaments, violates their structure and stabilizes blood microcirculation. Various allergic manifestations are possible, since a foreign protein is used in the composition. The risk of hemorrhage increases, as blood coagulation decreases.
"Streptokinase"
The country of manufacture of the medicine is Belarus. This is an effective drug for thrombolytic therapy for myocardial infarction. Available in powder form, which is used to make the solution. It is used strictly in a medical facility. This is due to its negative effects:
- Hemorrhage.
- Sudden changes in blood pressure.
- Tachycardia (increased heart rate from 90 beats per minute).
- Bradycardia (arrhythmia, which is manifested by a low heart rate).
The drug perfectly dissolves blood clots, improves the work of the left ventricle of the heart.
Urokinase
This is a thrombolytic drug, which is considered the main stimulator of plasmin. It contributes to the internal and external dissolution of the blood clot. The country of origin of Urokinase is Korea. To create it, use kidney cells. The effect of this medication is noticeable after about three to six hours. Probably hemorrhage, as well as bleeding during poisoning.
"Streptodekase"
Medication of a longer action. Country of origin - Russia. The tool affects blood coagulation. The following side effects are likely:
- Dizziness
- skin allergy;
- increase in body temperature.
"Thromboflux"
The medicine is used in advanced stages of the disease. This medication helps to drastically lower fibrinogen in the blood, which can trigger a brain hemorrhage. The following negative phenomena are likely:
- rashes;
- decrease in blood pressure;
- heart palpitations;
- bradycardia.
Country of origin - India.
The second generation of medicines
Names of thrombolytic drugs in this group:
- Alteplaza.
- Actilize.
- "Prourokinase."
- Gemaza.
- "Purolaza".
- "Metalization."
Alteplase is a remedy that has a reduced risk of bleeding. The medicine destroys blood clots, improving blood flow. It is used in the first hours after a heart attack or stroke, which reduces the likelihood of complications and even death.
"Actilize" is a thrombolytic, which is used for severe damage to veins and arteries. It is most effective at an early stage of clinical manifestations in the first one and a half to two hours after the onset of signs of a heart attack or stroke. The likelihood of complications is minimized.
"Prourokinase" is a medication that is different in that it has the least risk of bleeding. When using it, the following are possible:
- allergic reactions;
- tachycardia;
- arrhythmia.
Gemaza is a Russian medicine, which is produced in the form of a powder and is used, as a rule, in ophthalmology after surgical interventions and with a heart attack. When using, there is the least risk of bleeding.
"Purolase" is the medication that gives the greatest effect in case of thrombosis of the peripheral vessels of the legs, arms and heart attack in the first minutes after the first signs of the disease appear.
"Metalysis" is a drug that is distinguished by its selective action and less likely to cause bleeding. It is rarely used due to its high cost.
Third generation of medicines
Names of thrombolytic drugs:
- "Reteplaza."
- "Lanoteplaza."
- "Tenecteplase".
- "Antistreplaza."
Reteplase is a thrombolytic drug that has been used for a long time to improve microcirculation. In the course of the study, it was revealed that when using the medication the least risk of bleeding is manifested.
"Tenecteplase" is an effective tool that can quickly affect with little risk of bleeding. An activator of natural plasminogen transforms it into plasmin inside a blood clot.
"Lanoteplase" is a thrombolytic drug that is obtained as a result of genetic engineering. The drug does not cause allergies, in rare situations bleeding and hemorrhage of moderate severity are possible.
"Antistreplaza" is a medication that has a quick action on a blood clot. To obtain the desired result, it is enough to use the drug once. The dissolution of a blood clot is observed within forty-five minutes.
Fourth and fifth generation funds
These are modern thrombolytic drugs of a new generation. They quickly act in contrast to the plasminogen of the third form. Medicines combine the properties of drugs of previous generations.
Opinions
It is almost impossible to find reviews on thrombolytic drugs and therefore it is not possible to conclude which medication is better or worse, based on the responses of patients and doctors.
According to medical experts, it is known that the role of thrombolytic drugs in medicine is high, they help many people cope with the problem. The most popular are second-generation drugs. They passed enough checks, and also proved themselves well and have no obvious negative points.