Streptokinase

drugbox
IUPAC_name = Streptococci streptokinase


CAS_number = 9002-01-1
ATC_prefix = B01
ATC_suffix = AD01
ATC_supplemental = ATC|B06|AA55
PubChem =
DrugBank = BTD00028
chemical_formula = C₂₁₀₀H₃₂₇₈N₅₆₆O₆₆₉S₄
molecular_weight = 47286.7 g/mol
bioavailability =
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metabolism =
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Streptokinase is an extracellular metallo-enzyme produced by beta-haemolytic streptococcus and is used as an effective and cheap clot-dissolving medication in some cases of myocardial infarction (heart attack)cite journal |author=Sikri N, Bardia A |title=A history of streptokinase use in acute myocardial infarction |journal=Tex Heart Inst J |volume=34 |issue=3 |pages=318–27 |year=2007 |pmid=17948083 |pmc=1995058 |doi= |url=] and pulmonary embolism.cite journal |author=Meneveau N, Schiele F, Vuillemenot A, "et al" |title=Streptokinase vs alteplase in massive pulmonary embolism. A randomized trial assessing right heart haemodynamics and pulmonary vascular obstruction |journal=Eur. Heart J. |volume=18 |issue=7 |pages=1141–8 |year=1997 |month=July |pmid=9243149 |doi= |url=http://eurheartj.oxfordjournals.org/cgi/pmidlookup?view=long&pmid=9243149]

It belongs to a group of medications known as fibrinolytics, and works by activating plasminogen through cleavage to produce plasmin.

The half life of streptokinase is approximately 20 minutes (quoted in SPC).

Mechanism of action

Plasmin is produced in the blood to break down the major constituent of blood clots
fibrin, therefore dissolving clots once they have fulfilled their purpose in stopping bleeding. Extra production of plasmin caused by streptokinase breaks down unwanted blood clots, for example, in the lungs (pulmonary embolism). Streptokinase forms a complex in the plasma with plasminogen to form an activator complex. This complex then forms plasmin from unbound plasminogen. [Oxford Handbook of Clinical Medicine, 6th Edition.]

Administration

It is given intravenously as soon as possible after the onset of a heart attack (acute phase - myocardial infarction) to dissolve clots in the arteries of the heart wall. This reduces the amount of damage to the heart muscle. Streptokinase is a bacterial product so the body will build up an immunity to it. It is recommended that this medication should not be used again after four days from the first administration, as it may not be as effective and can also cause an allergic reaction. For this reason, it is usually given only for a person's first heart attack. Further thrombotic events could be treated with tPA. Overdose of Streptokinase or tPA can be treated with Aminocaproic acid.

Marketing

It is marketed in Chile as Streptase by Alpes Selection, under license of ZLB Behring from Marburg, Germany.

References