Various chemical reactions are constantly taking place in the body. Blood is a specific liquid, 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 medicines given intravenously to prevent blood clots from clogging blood vessels. Thrombosis can develop in the 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 already existing blood clot, and the rest prevent its formation. Themare used, as a rule, for preventive purposes.
Themselves thrombolytics are enzymes that come in liquid form into damaged vessels. Already 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 in case of a threat to life in a medical institution and under the supervision of a doctor.
How thrombolytics work
When the body cannot cope with already formed blood clots, specialized therapeutic agents are used. Fibrin is a protein that is responsible for viscosity. With its deficiency, a violation of the process of blood clotting and bleeding occurs, and with an increased content, blood clots form.
For the disintegration of a fibrin clot, plasmin is needed, which is constantly moving in the blood, but it may not be enough. To eliminate the clot, an enzymatic solution is poured into the 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 drug administration:
- Infusion is the slow introduction of a drug into a vein.
- bolus - a rapid infusion of a large dose of solution for an immediate reaction of the body.
- Mixed method - first a quick injection of the drug, and then a slow injection.
When is it appropriate 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. Medicines 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 tissue damage).
- Myocardial infarction (one of the forms of cardiac ischemia, which occurs with the occurrence of ischemic necrosis of a portion of the heart muscles, due to the absolute or relative insufficiency of its microcirculation).
- Pulmonary thromboembolism (blockage of the pulmonary artery or its branches with blood clots, which form more often in 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).
- Clot formation in the heart.
What thrombolytic drugs are used for myocardial infarction?
Prohibited use
The main disadvantage of thrombolytic drugs is an increased risk of bleeding, which worsens he alth and can aggravate the course of the disease. Before using medicines, you should familiarize yourself well with the recommendations, as they have relative and absolute limitations. Before therapy, the doctor must conduct a blood test and an electrocardiogram, and only after that prescribemedication.
Contraindications:
- Internal bleeding.
- Recent abdominal surgery.
- Surgery in the area of the spinal cord and brain.
- Hypertension (a disease in which there is sustained high blood pressure).
- Inflammation in the pericardium (lesion of the pericardial sac is more often of an infectious, rheumatic or post-infarction nature).
- Aortic aneurysm (expansion of a limited area of the aortic wall, resembling a spindle or sac-like formation in shape, or a diffuse increase in its lumen more than 2 times compared to the unchanged area).
- Acute pancreatitis (acute aseptic inflammatory lesion of the pancreas of demarcation type).
- Insufficient blood clotting.
- Individual reaction.
- Taking anticoagulants.
- Acute form of diathesis (a condition of the child's body, which is characterized by a tendency to develop certain diseases, such as respiratory infections).
- Diseases that lead to bleeding.
- Changes in the structure of cerebral vessels.
- High blood pressure.
- Diabetic retinal disease.
- Thrombophlebitis (thrombosis with inflammation of the vein wall and the formation of a blood clot that closes its lumen).
- Injuries to the head and spinal column.
- Severe burns.
- Complex fractures of limbs.
- Bleeding in the stomach or intestines.
Means of thisgroups are quickly eliminated from the body, so poisoning is extremely rare.
Classification of thrombolytic drugs
Currently there are five generations of drugs:
- The first generation are enzymes that exist in nature. They transform blood plasma and have a positive effect on accelerating the synthesis of plasmagen into plasmin. The active substances are isolated from the blood. Such medicines change clotting, thereby provoking severe bleeding. These substances act as foreign to the body, causing allergic manifestations. They help to get a quick effect, but due to the possibility of severe bleeding, they are used infrequently.
- The second generation are fibrin-specific preparations that were created artificially with the help of E. coli bacteria. They affect mainly blood clots, while there are no side reactions. A minimum of flaws makes them more popular at the present time.
- 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 are complex drugs that are fast and have a greater effect on blood clots compared to drugs of previous generations. Unfortunately, they are not yet sufficiently studied at the present time.
- The fifth generation is a combination of natural and recombinant active ingredients.
Medical listfirst generation
List of the most popular medicines:
- "Fibrinolysin".
- "Streptokinase".
- "Urokinase".
- "Streptodecaza".
- "Thromboflux".
"Fibrinolysin" is a natural enzyme that is isolated from donated blood and is produced in powder for intravenous injections. It acts on protein (protein) filaments, disrupts 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 clotting decreases.
Streptokinase
The country of origin of the medicine is Belarus. It is an effective drug for thrombolytic therapy in myocardial infarction. Available in the form of a powder, which is used to make a solution. Used strictly in a medical facility. This is due to its negative effects:
- Hemorrhage.
- Sudden changes in blood pressure.
- Tachycardia (increased heart rate above 90 beats per minute).
- Bradycardia (arrhythmias that are manifested by a low heart rate).
The drug perfectly dissolves blood clots, improves the functioning of the left ventricle of the heart.
Urokinase
This is a thrombolytic drug that is considered the mainplasmin stimulator. It promotes internal and external dissolution of the blood clot. The country of origin of "Urokinase" is Korea. To create it, kidney cells are used. The effect of this medication is noticeable after about three to six hours. Hemorrhage is likely, as well as bleeding from poisoning.
Streptodecaza
Medication with longer duration. Country of origin - Russia. The drug affects blood clotting. 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 provoke a brain hemorrhage. The following negative phenomena are likely:
- rashes;
- lower blood pressure;
- increased heart rate;
- bradycardia.
Producing country - India.
Second generation medicines
Names of thrombolytic drugs in this group:
- "Alteplaza".
- "Actilise".
- "Prourokinase".
- "Gemaza".
- "Purolase".
- "Metalise".
"Alteplase" is a remedy that has a reduced risk of bleeding. The medicine breaks down blood clots, improving blood flow. It is used in the first hours after a heart attack or stroke, which reduces the likelihoodcomplications and even death.
"Actilyse" is a thrombolytic, which is used for severe damage to the veins and arteries. It shows the greatest effectiveness 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 drug that differs in that it has the lowest risk of bleeding. When using it, the following are possible:
- allergic reactions;
- tachycardia;
- arrhythmia.
"Gemaza" is a Russian medicine that is produced in the form of a powder and is usually used in ophthalmology after surgery and in case of a heart attack. When used, there is the least risk of bleeding.
"Purolase" is a medication that gives the greatest effect in case of thrombosis of peripheral vessels of the legs, arms and heart attack in the first minutes after the first signs of illness appear.
Metalise is a drug that is selective and less likely to bleed. Rarely used due to high cost.
Third generation medicines
Names of thrombolytic drugs:
- "Reteplase".
- "Lanoteplase".
- "Tenecteplaza".
- "Antisreplaza".
"Reteplase" is a thrombolytic agent that is used for a long time to improve microcirculation. The study revealed that the use of the drug shows the lowest risk of bleeding.
"Tenecteplase" is an effective remedy that can act quickly with little risk of bleeding. The natural plasminogen activator transforms it into plasmin inside the clot.
"Lanoteplase" is a thrombolytic agent, which was 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 medicine that has a rapid effect on a blood clot. To obtain the desired result, it is enough to apply the drug once. The dissolution of the blood clot is observed within forty-five minutes.
Fourth and fifth generation funds
These are modern thrombolytic drugs of a new generation. They act quickly, unlike the third form of plasminogen. Medicines combine the properties of drugs of previous generations.
Opinions
Reviews on thrombolytic drugs are almost impossible to find, and therefore it is not possible to conclude which medication is better or worse based on the responses of patients and doctors.
According to the reviews of medical specialists, it is known that the role of thrombolytic drugs in medicine is high, they help manypeople to deal with the problem. The second generation drugs are considered the most popular. They have passed enough tests, and also have proven themselves well and have no obvious negative points.
