Fibrinolytics are used to break up a thrombus that is already present and is blocking a coronary artery.
Mechanism of action: Plasminogen activators. They convert plasminogen to plasmin, which in turn dissolves the fibrin clot.
Indications: Acute coronary syndrome (ACS): Myocardial infarction (both STEMI and NSTEMI) and unstable angina (UA).
Examples: Alteplase (Activase), Streptokinase (Streptase), Tenecteplase (TNKase), and Reteplase (Retevase).
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Anticoagulants are mainly used as a prophylaxis of thrombus (DVT or stroke prophylaxis). However, some of them can also be used for the treatment of an established thrombus (ACS).
Mechanism of action: differs by the type of the anticoagulant.
Indications: DVT and stroke prophylaxis. Some are used for treatment of ACS.
Examples: Heparin (unfractionated and low molecular weight), direct thrombin inhibitors (argatroban, bivalirudin, and lepirudin), dabigatran (Pradaxa), rivaroxaban (Xartello), and warfarin.
Reference:
DiPiro J. Pharmacotherapy: A Pathophysiologic Approach. 8th ed. New York: McGraw-Hill; 2011.
Fibrinolytics are used to break up a thrombus that is already present and is blocking a coronary artery.
Mechanism of action: Plasminogen activators. They convert plasminogen to plasmin, which in turn dissolves the fibrin clot.
Indications: Acute coronary syndrome (ACS): Myocardial infarction (both STEMI and NSTEMI) and unstable angina (UA).
Examples: Alteplase (Activase), Streptokinase (Streptase), Tenecteplase (TNKase), and Reteplase (Retevase).
—
Anticoagulants are mainly used as a prophylaxis of thrombus (DVT or stroke prophylaxis). However, some of them can also be used for the treatment of an established thrombus (ACS).
Mechanism of action: differs by the type of the anticoagulant.
Indications: DVT and stroke prophylaxis. Some are used for treatment of ACS.
Examples: Heparin (unfractionated and low molecular weight), direct thrombin inhibitors (argatroban, bivalirudin, and lepirudin), dabigatran (Pradaxa), rivaroxaban (Xartello), and warfarin.
Reference:
DiPiro J. Pharmacotherapy: A Pathophysiologic Approach. 8th ed. New York: McGraw-Hill; 2011.
عن المُجيب
أخصائية صيدلة علاجية، حاصلة على البورد الأمريكي في الصيدلة العلاجية. مبتعثة من جامعة الملك عبد العزيز بجدة.