II. Background

  1. Isolated from Group C Beta-hemolytic Streptococcus

IV. Contraindications

  1. Conditions in which streptococcal Antibody is more likely to be present (risk of severe Allergic Reaction)
    1. Prior exposure to Streptokinase
    2. Recent streptococcal infection

V. Mechanism

  1. Activates plasminogen to plasmin
    1. Unlike tPA, does not bind Fibrin first before activating plasminogen (not clot specific)
  2. Plasmin breaks down both Fibrin and Fibrinogen to Fibrin
    1. Fibrin Degradation Products result, which in turn also act to inhibit Fibrin formation
  3. Benefits
    1. Lasts longer than T-PA (duration 24 hours)
    2. Less bleeding risk
      1. Probably less risk than T-PA in over age 75

VI. Dosing

  1. Streptokinase 1.5 million units over 60 minutes
  2. Premedication
    1. Hydrocortisone 100 mg IV
    2. Diphenhydramine 25 mg IV

VII. Adverse Effects

  1. See Thrombolytic
  2. Major Bleeding (e.g. Intracranial Hemorrhage)
  3. Severe Allergic Reaction

VIII. Pharmacokinetics

  1. Half-Life: 83 minutes
    1. Reduced to 12 min in patients with antibodies to Streptokinase from prior streptococcal infection

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Ontology: Streptokinase (C0038418)

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