Fibrinolytic therapy

Fibrinolytic therapy is a type of medical treatment that is used to dissolve blood clots in the body. This therapy is often used in the treatment of conditions such as myocardial infarction (heart attack), stroke, and pulmonary embolism.

Mechanism of Action

Fibrinolytic therapy works by activating the body's natural fibrinolysis process. This process involves the breakdown of fibrin, a protein that forms the framework of blood clots. The main agents used in fibrinolytic therapy are tissue plasminogen activator (tPA), streptokinase, and urokinase. These agents work by converting the inactive plasminogen into its active form, plasmin, which then breaks down fibrin and dissolves the clot.

Indications

Fibrinolytic therapy is indicated in certain acute medical conditions where rapid dissolution of a blood clot can significantly improve the patient's prognosis. These conditions include:

• Myocardial infarction: Fibrinolytic therapy is often used in the early treatment of a heart attack, especially when percutaneous coronary intervention (PCI) is not immediately available.
• Stroke: In certain types of ischemic stroke, fibrinolytic therapy can be used to dissolve the clot and restore blood flow to the brain.
• Pulmonary embolism: In cases of massive or submassive pulmonary embolism, fibrinolytic therapy can be used to dissolve the clot in the pulmonary arteries.

Contraindications

Fibrinolytic therapy is contraindicated in patients with a high risk of bleeding, including those with recent surgery, active bleeding, or a history of hemorrhagic stroke. It is also contraindicated in patients with severe uncontrolled hypertension.

Side Effects

The most common side effect of fibrinolytic therapy is bleeding, including hemorrhage and bruising. Other potential side effects include allergic reactions, fever, and low blood pressure.

See Also

• Anticoagulation
• Thrombolysis
• Hemostasis