II. Background
- Isolated from Group C Beta-hemolytic Streptococcus
III. Indications
- Replaced by Recombinant Tissue Plasminogen Activator (r-tPA)
- Historical Uses
- ST Elevation Myocardial Infarction (STEMI
- Pulmonary Embolism
- Hemodialysis shunt thrombosis
IV. Contraindications
- Conditions in which streptococcal Antibody is more likely to be present (risk of severe Allergic Reaction)
- Prior exposure to Streptokinase
- Recent streptococcal infection
V. Mechanism
- Activates plasminogen to plasmin
- Unlike tPA, does not bind Fibrin first before activating plasminogen (not clot specific)
- Plasmin breaks down both Fibrin and Fibrinogen to Fibrin
- Fibrin Degradation Products result, which in turn also act to inhibit Fibrin formation
- Benefits
- Lasts longer than T-PA (duration 24 hours)
- Less bleeding risk
- Probably less risk than T-PA in over age 75
VI. Dosing
- Streptokinase 1.5 million units over 60 minutes
- Premedication
- Hydrocortisone 100 mg IV
- Diphenhydramine 25 mg IV
VII. Adverse Effects
- See Thrombolytic
- Major Bleeding (e.g. Intracranial Hemorrhage)
- Severe Allergic Reaction
VIII. Pharmacokinetics
-
Half-Life: 83 minutes
- Reduced to 12 min in patients with antibodies to Streptokinase from prior streptococcal infection
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Definition (MSH) | Streptococcal fibrinolysin . An enzyme produced by hemolytic streptococci. It hydrolyzes amide linkages and serves as an activator of plasminogen. It is used in thrombolytic therapy and is used also in mixtures with streptodornase (STREPTODORNASE AND STREPTOKINASE). EC 3.4.-. |
Definition (CSP) | nonEC; enzyme elaborated by hemolytic streptococci which produces fibrinolysis by activating plasminogen to plasmin; it is used as a thrombolytic agent. |
Concepts | Pharmacologic Substance (T121) , Amino Acid, Peptide, or Protein (T116) , Enzyme (T126) |
MSH | D013300 |
SnomedCT | 319810009, 395889004, 20847002 |
LNC | LP16489-4, MTHU021627 |
English | Streptokinase, streptokinase, streptokinase (medication), Streptokinase [Chemical/Ingredient], SK - Streptokinase, Streptokinase (product), Streptokinase (substance), Streptokinase preparation (substance), STREPTOKINASE, Streptokinase preparation, Streptokinase agent (substance), Streptokinase agent |
Spanish | preparado de estreptoquinasa (sustancia), preparado de estreptoquinasa, estreptoquinasa (producto), estreptocinasa, estreptoquinasa, estreptocinasa (sustancia), estreptokinasa, estreptoquinasa (sustancia), estreptocinasa (producto), Estreptocinasa, estreptokinasa (producto), estreptokinasa (sustancia), Estreptoquinasa |
Swedish | Streptokinas |
Czech | streptokinasa |
Finnish | Streptokinaasi |
Russian | NEITRAL'NAIA PROTEINAZA STAPHYLOCOCCUS AUREUS, STREPTOKINAZA, STREPTAZA, НЕЙТРАЛЬНАЯ ПРОТЕИНАЗА STAPHYLOCOCCUS AUREUS, СТРЕПТАЗА, СТРЕПТОКИНАЗА |
Japanese | ストレプトキナーゼ |
Croatian | STREPTOKINAZA |
Polish | Streptokinaza |
Norwegian | Not Translated[Streptokinase] |
French | Streptokinase |
German | Streptokinase |
Italian | Streptochinasi |
Portuguese | Estreptoquinase |