関: fibrinolytic agent、thrombolytic、thrombolytic drug

WordNet

a kind of pharmaceutical that can break up clots blocking the flow of blood to the heart muscle (同)thrombolytic_agent, clot buster

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2017/01/11 20:17:03」(JST)

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Thrombolytic drugs are used in medicine to dissolve blood clots in a procedure termed thrombolysis. They limit the damage caused by the blockage (occlusion) of a blood vessel.^[1] Thrombolytic agents can be differentiated from fibrinolytic agents which only dissolve the fibrin while thrombolysis refers to the dissolution of the entire thrombus.

Uses

Thrombolytic agents are used for the treatment of myocardial infarction (heart attack),^[2] thromboembolic strokes, deep vein thrombosis and pulmonary embolism to clear a blocked artery and avoid permanent damage to the perfused (see perfusion) tissue (e.g. myocardium, brain, leg) and death.^[3] They may also be used to clear blocked catheters that are used in long-term medical therapy.

Thrombolytic therapy in hemorrhagic strokes is contraindicated, as its use in that situation would prolong bleeding into the intracranial space and cause further damage.

Members

The thrombolytic drugs include:

tissue plasminogen activator t-PA:

alteplase (Activase)
reteplase (Retavase)
tenecteplase (TNKase)

anistreplase (Eminase)
streptokinase (Kabikinase, Streptase)
urokinase (Abbokinase)

These drugs are most effective if administered immediately after it has been determined they are clinically appropriate. The advantage of administration is highest within the first sixty minutes after a thrombotic event, but may extend up to six hours after the start of symptoms.

These drugs are often administered in combination with anticoagulant drugs such as intravenous heparin or low molecular weight heparin, for synergistic antithrombotic effects and secondary prevention.

Side-effects

Hemorrhagic stroke is a rare but serious complication of thrombolytic therapy. If a patient has had thrombolysis before, an allergy against the thrombolytic drug may have developed (especially after streptokinase). If the symptoms are mild, the infusion is stopped and the patient is commenced on an antihistamine before infusion is recommenced. Anaphylaxis generally requires immediate cessation of thrombolysis.

References

^ "Thrombolytic therapy".
^ Ellen C Keeley; Judith A Boura; Cindy L Grines (4 January 2003). "Primary angioplasty versus intravenous thrombolytic therapy for acute myocardial infarction: a quantitative review of 23 randomised trials". The Lancet. 361 (9351): 13–20. doi:10.1016/S0140-6736(03)12113-7. PMID 12517460.
^ Selim M. Arcasoy, MD; John W. Kreit (June 1999). "Thrombolytic Therapy of Pulmonary Embolism: A Comprehensive Review of Current Evidence". Chest Journal. 115 (6): 1695–1707. doi:10.1378/chest.115.6.1695.

UpToDate Contents

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1. 急性肺塞栓症および下肢深部静脈血栓症における線溶（血栓溶解）療法 fibrinolytic thrombolytic therapy in acute pulmonary embolism and lower extremity deep vein thrombosis
2. 急性虚血性脳卒中における経静脈的線維素溶解（血栓溶解）治療：治療的使用 intravenous fibrinolytic thrombolytic therapy in acute ischemic stroke therapeutic use
3. ST上昇型心筋梗塞における血栓溶解療法の特性および臨床試験 characteristics of fibrinolytic thrombolytic agents and clinical trials in acute st elevation myocardial infarction
4. 急性ST上昇型心筋梗塞の血栓溶解療法：治療開始 fibrinolysis for acute st elevation myocardial infarction initiation of therapy
5. 下肢の急性動脈閉塞（急性下肢虚血）の概要 overview of acute arterial occlusion of the extremities acute limb ischemia

English Journal

Endovascular Treatment of Thrombosis and Embolism.

Goktay AY1, Senturk C2.
Advances in experimental medicine and biology.Adv Exp Med Biol.2017;906:195-213.
Deep venous thrombosis (DVT) is a common disorder with a significant mortality rate. Successful endovascular treatment of acute DVT is most likely to be achieved in patients with recently formed thrombus, (<10-14 days) with acute iliofemoral DVT. Endovascular treatment options include: Catheter-d
PMID 27664152

Safety and efficacy of tenecteplase versus alteplase in acute coronary syndrome: a systematic review and meta-analysis of randomized trials.

Guillermin A1, Yan DJ1, Perrier A2, Marti C3.
Archives of medical science : AMS.Arch Med Sci.2016 Dec 1;12(6):1181-1187. Epub 2016 Mar 31.
INTRODUCTION: Alteplase and tenecteplase are two widely used thrombolytic agents and are both approved for the treatment of acute myocardial infarction. These two molecules have increased fibrin specificity compared with older thrombolytics but distinct pharmacokinetic properties and may differ in t
PMID 27904506

Histologic features of acute thrombi retrieved from stroke patients during mechanical reperfusion therapy.

Ahn SH1, Hong R2, Choo IS3, Heo JH4, Nam HS4, Kang HG3, Kim HW3, Kim JH3.
International journal of stroke : official journal of the International Stroke Society.Int J Stroke.2016 Dec;11(9):1036-1044. Epub 2016 Apr 7.
BACKGROUND: The histologic features of thrombus may differ according to the stroke subtypes. However, in acute reperfusion therapy, fibrin-specific thrombolytics are used based on the assumption that all thrombi are alike.AIMS: The histologic characteristics of thrombi were compared between patients
PMID 27056965

Japanese Journal

Early Reperfusion in STEMI Influences Transmural Injury Characteristics and Electrocardiographic Manifestations

Kim Mihyun,Hwang Hye Jin,Joung Boyoung,Pak Hui-Nam,Lee Moonhyoung
Journal of Arrhythmia 27(Supplement), PE4_049-PE4_049, 2011
… All underwent cardiac magnetic resonance (CMR) and ECG 14±10 days after reperfusion therapy with direct percutaneous coronary intervention (PCI) (n=23, 92%) and thrombolytics (n=2, 8%). …
NAID 130002129698

Association of Renal Insufficiency With In-Hospital Mortality Among Japanese Patients With Acute Myocardial Infarction Undergoing Percutaneous Coronary Interventions

Hirakawa Yoshihisa,Masuda Yuichiro,Kuzuya Masafumi,Iguchi Akihisa,Kimata Takaya,Uemura Kazumasa
International Heart Journal 47(5), 745-752, 2006
… Vasopressors, an intra-aortic balloon pump, and mechanical ventilation were frequently used in the patients with renal insufficiency, while thrombolytics were used less frequently. …
NAID 130000068771

Effect of pexelizumab, an anti-C5 complement antibody, as adjunctive therapy to fibrinolysis in acute myocardial infarction : The COMPlement inhibition in myocardial infarction treated with thromboLYtics (COMPLY) Trial

MAHAFFEY KW
Circulation 108, 1176-1183, 2003
NAID 30022668957

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リンク元	「fibrinolytic agent」「thrombolytic drug」
関連記事	「thrombolytic」

「fibrinolytic agent」

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血栓溶解薬、線溶剤、線維素溶解薬

関: antithrombotic agent、fibrinolytic drug、thrombolytic、thrombolytic agent、thrombolytic drug、thrombolytics

「thrombolytic drug」

　　[★]

血栓溶解薬、血栓溶解剤

関: antithrombotic agent、fibrinolytic agent、fibrinolytic drug、thrombolytic、thrombolytic agent、thrombolytics

「thrombolytic」

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adj.

血栓溶解の

n.

血栓溶解薬、血栓溶解剤

関: fibrinolytic agent、thrombolysis、thrombolytic agent、thrombolytic drug、thrombolytics

[1] "Thrombolytic therapy".

[2] Ellen C Keeley; Judith A Boura; Cindy L Grines (4 January 2003). "Primary angioplasty versus intravenous thrombolytic therapy for acute myocardial infarction: a quantitative review of 23 randomised trials". The Lancet. 361 (9351): 13–20. doi:10.1016/S0140-6736(03)12113-7. PMID 12517460.

[3] Selim M. Arcasoy, MD; John W. Kreit (June 1999). "Thrombolytic Therapy of Pulmonary Embolism: A Comprehensive Review of Current Evidence". Chest Journal. 115 (6): 1695–1707. doi:10.1378/chest.115.6.1695.

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thrombolytics