When is fibrinolytic therapy not appropriate?
When the decision to treat a patient experiencing a STEMI with fibrinolytic therapy is made, because primary PCI is not available in a timely fashion, contraindications must be considered; suspected aortic dissection, active bleeding (excluding menses) or a bleeding diathesis are contraindications to fibrinolytic …
Do you give aspirin with fibrinolytic therapy?
Persons given intravenous r-TPA should not receive aspirin, heparin, warfarin, ticlopidine, or other antithrombotic or antiplatelet aggregating drugs within 24 hours of treatment (Grade A recommendation).
What is role of Fibrinolytics in myocardial infarction and stroke?
The aim of fibrinolytics is to dissolve blood clots that can cause serious and potentially life-threatening damage if not removed in a timely manner. The mechanism of this benefit relates to maximizing tissue salvage by early restoration of blood flow and thereby enhancing both early and long-term survival.
What is fibrinolytic therapy for STEMI?
Four fibrinolytic agents are approved for the treatment of STEMI in the United States-streptokinase, alteplase, reteplase, and tenecteplase. Several clinical trials have demonstrated the beneficial effects of these therapies in reducing mortality rates in patients with suspected acute myocardial infarction.
Is fibrinolytic therapy as effective as Ppci?
Mechanical revascularization, or primary percutaneous coronary intervention (PPCI), of the infarct artery is the preferred method of restoring coronary perfusion because of its superior efficacy and decreased risk of complications compared with fibrinolytic therapy.
How do you know if a patient is candidate for fibrinolytic therapy?
Fibrinolytic therapy works by dissolving clots which are obstructing blood flow to the brain. In order to be considered a suitable candidate for the therapy, patients must be over the age of 18 and have a firm diagnosis of ischemic stroke with deficits.
Who gets fibrinolytic therapy?
Patients older than 75 years derive significant benefit from fibrinolytic therapy, even though their risk of bleeding is higher. Fibrinolytic agents are given in conjunction with antithrombin and antiplatelet agents, which help to maintain vessel patency once the clot has been dissolved.
What are hemorrhagic complications?
The most feared complication of fibrinolysis is intracranial hemorrhage (ICH), but serious hemorrhagic complications can occur from bleeding at any site in the body. Risk factors for hemorrhagic complications include the following: Increasing age. Lower body weight.
