Thrombolytics Unveiled: Mechanism, Uses, and Risks of Streptokinase & Urokinase

Thrombolytics

List of Thrombolytic Agents

Streptokinase
Urokinase
Alteplase (tPA)
Reteplase
Tenecteplase

Mechanism of Action

Thrombolytics convert plasminogen → plasmin, which dissolves fibrin clots.
Streptokinase forms a complex with plasminogen to activate it.
Urokinase directly activates plasminogen.

Streptokinase

Mechanism: Forms complex with plasminogen → converts to plasmin → fibrin degradation
Indications:

Acute myocardial infarction (AMI)
Pulmonary embolism
Deep vein thrombosis (DVT)

Adverse Effects:

Bleeding
Hypotension
Allergic reactions (foreign protein)

Contraindications:

Recent surgery
Active bleeding
History of stroke
Hypersensitivity to streptococci

Urokinase

Mechanism: Direct plasminogen activator
Indications:

Pulmonary embolism
Catheter clearance

Adverse Effects:

Hemorrhage
Rare allergic reactions

Contraindications:

Active internal bleeding
Recent cerebrovascular accident
Severe uncontrolled hypertension

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