Paper I
2023 July (Supplementary) (2019 Scheme) · 100 marks · 180 min

Question

Streptokinase.

Q94 marksShort Answers

Answer

Streptokinase is a fibrinolytic (thrombolytic) agent derived from beta-hemolytic streptococci.

MOA: forms a complex with plasminogen, which then converts free plasminogen to plasmin; plasmin degrades fibrin, dissolving the thrombus.

Uses: acute myocardial infarction (within the therapeutic window, when primary PCI is unavailable), acute massive pulmonary embolism, acute ischemic stroke (in select settings), deep vein thrombosis.

Adverse effects: bleeding (the major risk), hypersensitivity/allergic reactions (being a bacterial protein — antibodies develop after use, precluding repeat administration within roughly 6-12 months and reducing efficacy of a second course), hypotension. Antibody development is a specific disadvantage streptokinase has over the newer, non-antigenic recombinant agents (Alteplase, Tenecteplase).

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