Urokynaza

When ATH:
B01AD04

Characteristic

Фермент — активатор плазминогена, obtained from human kidney cell cultures.

Pharmacological action

Fibrinolytic.

Application

Acute arterial and venous thrombosis, thromboembolism pulmonary artery branches, острый инфаркт миокарда в первые 3–6 ч, unstable angina, arteryovenoznoho shunt thrombosis, obliterating atherosclerosis of the lower and upper limbs, Primary hypertension, pulmonary circulation.

Contraindications

Bleeding (ongoing or recently stopped), incl. first 72 hours after surgery (especially neurosurgical), at a recent biopsy and puncture the artery (during 10 days), 10 days postpartum; ulcers or stomach cancer, Cerebral thrombosis (incl. history), severe hypertension, vnutricherepnaya injury, brain tumor, blood clotting (especially in severe renal or hepatic impairment), bleeding tumor, acute pulmonary edema, diabeticheskaya gemorragicheskaya retinopathy, thrombosis of the vertebral or carotid artery, bacterial endocarditis (subacute), auricular fibrillation, mytralnыy stenosis, I trimester of pregnancy.

Restrictions apply

The active form of tuberculosis, chronic renal failure or severe hepatocellular, senium (after 70 years).

Side effects

Bleeding in the areas of perfusion (especially when it is the duration of a 48 no), bleeding (gums, Intestinal); редко — пурпура, embolism, a blood clot fragments lysed primary, fever, moderate decrease in hematocrit.

Cooperation

Increase the likelihood of bleeding drugs, affecting blood coagulation (Heparin), platelet function (NSAIDs, dipiridamol), leading to the development of ulcerations and bleeding from the gastrointestinal tract. Indirect anticoagulants and acetylsalicylic acid increases the risk of spontaneous bleeding into the mediastinum. The effect of inhibitors reduced fibrinolysis (epsilon-aminocaproic acid, etc..).

Dosing and Administration

B /, B / A, locally (endookulyarno, intrapleural, endokoronarno). Before / v infusion active substance diluted in saline or 5% glucose solution. Use small, medium and high doses. Кратковременный курс предусматривает введение 500000 ЕД за 2 no. Therapy combined with constant / infusion of small doses of heparin (1000 ЕД/кг в час). Тромбоэмболия легочной артерии — в/в 4000 ЕД/кг в течение 10 m, затем в течение 12–24 ч непрерывно капельно — по 4000 U / kg. The regional administration is carried out, using angiographic catheter, within from 5 minutes to 2 no. Периферический артериальный и венозный тромбоз — в/в за 20 мин вводят насыщающую дозу 250000 ED, затем непрерывно за 12 ч — еще 750000 ED. Инфаркт миокарда — в/в, during 6 ч после появления первых симптомов заболевания, introduced 250000 ЕД с последующей инфузией 100000 ЕД/ч в течение 12 no. Intracoronary administered together with plasminogen. Кровоизлияние в переднюю камеру глаза — разводят в стерильной бидистиллированной воде и медленно, repeatedly, washed anterior chamber. Arteryovenoznoho shunt thrombosis: вводят непосредственно в тромбированный шунт и оставляют в нем в течение 1–2 ч.

Precautions

To use caution during the first 18 weeks of pregnancy (possible placental abruption), in the case of aneurysm, recently held cardiopulmonary resuscitation in cases of suspected internal injuries. Avoid introduction of dextran to restore blood volume due to possible disaggregation of platelets. Do not mix in the same syringe or in a solution for the on / in the introduction to others. Drug.

Cautions

Treatment is carried out under close clinical (hemorrhagic syndrome, hematuria, etc.) and laboratory (every 4-6 hours) control. Fibrinogen level in the blood must not fall below 100 mg%. После прекращения терапии необходимо вводить в/в капельно гепарин — 5000–10000 ЕД каждые 12 ч под контролем тромбинового и тромбопластинового времени. With the development of massive internal and external bleeding should stop administering the drug. To stop the bleeding (in cases of emergency) use of epsilon-aminocaproic acid, Human fibrinogen, transfusion of fresh blood.