The Effects of Fibrinolytic Drugs:

Fibrinolytic drugs:

  • also called thrombolytic drugs
  • any medication that is capable of stimulating the dissolution of a blood clot
  • work by activating the fibrinolytic pathway

Fibrinolytic drugs are different from anticoagulant drugs (commonly known as coumarin derivatives and heparin). Anticoagulant drugs prevent the formation of blood clots by suppressing the function of multiple clotting factors that are normal and present in the blood.

Fibrinolytic Medications Indications for Use:

The most common indications for the use of fibrinolytic medications include:

  • acute myocardial infarction
  • acute ischemic stroke

In acute myocardial infarction (AMI) patients, fibrinolytic medications would be indicated if the ST segment elevation is consistent with an MI of greater than or equal to 1mm in two or more contiguous leads.  It may also be indicated if the signs and symptoms of AMI last more than 15 minutes and less than 12 hours and PCI is not available within 90 minutes of medical contact.

If the indication is related to ischemic stroke, patients may qualify if they suffer sudden onset of focal neurologic deficit, such as:

  • Slurred speech
  • Facial droop
  • One-sided weakness
  • One-sided paralysis
  • Or the stroke symptoms do not seem to self-resolve, and the signs and symptoms are present for up to 3 hours but not greater than 4.5 hours.

Fibrinolytic Agents Precautions & Contraindications:

Reasons to exclude use of fibrinolytic drugs include, but may not be limited to, the following:

  • Hypertension with systolic blood pressure greater than 180-200 mm HG
  • Right arm versus left arm blood pressure differences greater than 15 mm HG
  • Significant head or facial trauma within the past 3 months
  • Prior intracranial hemorrhage
  • Bleeding disorder or internal bleeding within the last 2 to 4 weeks
  • Patient is on a current anticoagulant treatment
  • Pregnancy
  • Ischemic stroke greater than 3 hours or less than 3 months, not including the current condition being considered for the current fibrinolytic treatment
  • Serious systemic disease, including advanced cancer or kidney disease

Adult Dosage for Fibrinolytic Agents:

The dose of fibrinolytic treatments depends on the fibrinolytic being used.