4/29/2018 Thrombolytics - Hematology - Medbullets Step 1

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
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Thrombocytopenic Purpura
(TTP)  


Hemolytic Uremic
Thrombolytics  3  0  0  4  1
 Hematology Medbullets

Syndrome (HUS)
Team
MIXED
PLATELET/COAGULATION


DISORDERS Overview
Von Willebrand Disease
Thrombolytics
Disseminated Intravascular catalyze the
Coagulation (DIC)
formation of
Heparin-Induced endogenous
Thrombocytopenia (HIT)
plasmin from
HYPERCOAGULABLE 
plasminogen
STATES precursor
plasmin is
Factor V Leiden
a serine
Prothrombin Gene protease
Mutation
that
Antithrombin III Deficiency degrades
Protein C/S Deficiency clots (thrombi)
Drugs
CANCER (SEE 
tPA (alteplase)
ONCOLOGY)
streptokinase
HEME DISORDERS

urokinase
APSAC (anistreplase)
Heme Synthesis, Mechanism
Porphyrias, and Lead
Poisoning catalyze conversion of plasminogen to plasmin
cleaves fibrin clots
Methemoglobinemia
cleaves thrombin
Acute Intermittent clot-specificity
Porphyria
tPA is clot-specific
 PHARMACOLOGY acts only on fibrin-bound
plasminogen
RBC/WBC streptokinase is not clot specific


depletes circulating
Transfusion
plasminogen, factor V,
Filgrastim / Sargramostim factor VIII
Erythropoietin ↑ PT, ↑ PTT, no change in platelet count
Clinical use
COAGULATION administer as early as possible following


Anticoagulants ischemic stroke (tPA)

MI
Thrombolytics
DVT
Antiplatelet Drugs pulmonary embolism

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Toxicity
bleeding and intracerebral hemorrhage
contraindicated in patients with
history of bleeding, surgery,
hypertension
  streptokinase may cause hypersensitivity
 Hematology derived from β-hemolytic
streptococci
Antagonist
aminocaproic acid and tranexamic acid
inhibitor of fibrinolysis

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