Thrombolysis

Revision as of 21:42, 6 December 2013 by ShiSheng (talk | contribs) (→‎Uses)
(diff) ← Older revision | Latest revision (diff) | Newer revision → (diff)
Jump to navigation Jump to search

WikiDoc Resources for Thrombolysis

Articles

Most recent articles on Thrombolysis

Most cited articles on Thrombolysis

Review articles on Thrombolysis

Articles on Thrombolysis in N Eng J Med, Lancet, BMJ

Media

Powerpoint slides on Thrombolysis

Images of Thrombolysis

Photos of Thrombolysis

Podcasts & MP3s on Thrombolysis

Videos on Thrombolysis

Evidence Based Medicine

Cochrane Collaboration on Thrombolysis

Bandolier on Thrombolysis

TRIP on Thrombolysis

Clinical Trials

Ongoing Trials on Thrombolysis at Clinical Trials.gov

Trial results on Thrombolysis

Clinical Trials on Thrombolysis at Google

Guidelines / Policies / Govt

US National Guidelines Clearinghouse on Thrombolysis

NICE Guidance on Thrombolysis

NHS PRODIGY Guidance

FDA on Thrombolysis

CDC on Thrombolysis

Books

Books on Thrombolysis

News

Thrombolysis in the news

Be alerted to news on Thrombolysis

News trends on Thrombolysis

Commentary

Blogs on Thrombolysis

Definitions

Definitions of Thrombolysis

Patient Resources / Community

Patient resources on Thrombolysis

Discussion groups on Thrombolysis

Patient Handouts on Thrombolysis

Directions to Hospitals Treating Thrombolysis

Risk calculators and risk factors for Thrombolysis

Healthcare Provider Resources

Symptoms of Thrombolysis

Causes & Risk Factors for Thrombolysis

Diagnostic studies for Thrombolysis

Treatment of Thrombolysis

Continuing Medical Education (CME)

CME Programs on Thrombolysis

International

Thrombolysis en Espanol

Thrombolysis en Francais

Business

Thrombolysis in the Marketplace

Patents on Thrombolysis

Experimental / Informatics

List of terms related to Thrombolysis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Thrombolysis is the breakdown (lysis) of blood clots by pharmacological means. It is colloquially referred to as clot busting for this reason. It works by stimulating fibrinolysis by plasmin through infusion of analogs of tissue plasminogen activator, the protein that normally activates plasmin.

Agents

Thrombolysis requires the use of thrombolytic drugs, which are either derived from Streptomyces spp. or (more recently) the effect of recombinant technology, where human activators of plasminogen (e.g. tissue plasminogen activator, tPA) are manufactured by bacteria.

Some commonly used thrombolytics are

Principles

Formation of blood clots lies at the basis of a number of serious diseases (see below). By breaking down the clot, the disease process can be arrested, or the complications reduced. While other anticoagulants (such as heparin) decrease the "growth" of a clot, thrombolytic agents actively reduce the size of the clot.

All thrombolytic agents work by activating the enzyme plasminogen, which clears the cross-linked fibrin mesh (the backbone of a clot). This makes the clot soluble and subject to further proteolysis by other enzymes, and restores blood flow over occluded blood vessels.

Uses

Diseases where thrombolysis is used:

Apart from streptokinase, all thrombolytic drugs are administered together with heparin (unfractionated or low molecular weight heparin), usually for 24-48 hours.

Thrombolysis is usually intravenous. It may also be used during an angiogram (intra-arterial thrombolysis), e.g. when patients present with stroke beyond three hours.

In some settings, emergency medical technicians may administer thrombolysis for heart attacks in prehospital settings.

Contradictions

These are contraindicated in bleeding disorders, active bleeding and when there has been recent surgery. Diabetic retinopathy is a relative contraindication, as is untreated high blood pressure. Warfarin treatment increases risk of bleeding and is a relative contraindication.

Streptokinase is contraindicated in patients who have been previously treated with streptokinase, as there is a risk of anaphylaxis (life-threatening allergic reaction) due to the production of antibodies against the enzyme.

References

  • Wardlaw JM, Zoppo G, Yamaguchi T, Berge E (2003). "Thrombolysis for acute ischaemic stroke". Cochrane Database Syst Rev (3): CD000213. PMID 12917889.


nl:Trombolyse uk:Тромболітична терапія

Template:WikiDoc Sources