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Related to streptokinase: urokinase


an enzyme produced by streptococci that catalyzes the conversion of plasminogen to plasmin. It is administered intravenously as a thrombolytic agent in the treatment of acute coronary arterial thrombosis, acute pulmonary embolism, deep venous thrombosis, and acute arterial thromboembolism or thrombosis. It is also used to clear obstructed arteriovenous cannulae. Detailed and skilled control is required in its use in order to avoid hemorrhage. It also can produce severe antigenic reactions upon readministration. See also anticoagulant.
streptokinase-streptodornase a mixture of enzymes elaborated by hemolytic streptococci; used as a proteolytic and fibrinolytic agent.
Miller-Keane Encyclopedia and Dictionary of Medicine, Nursing, and Allied Health, Seventh Edition. © 2003 by Saunders, an imprint of Elsevier, Inc. All rights reserved.



Pharmacologic class: Group C beta-hemolytic streptococcal nonenzymatic protein

Therapeutic class: Thrombolytic

Pregnancy risk category C


Converts plasminogen to plasmin, an enzyme that degrades fibrin clots and lyses thrombi and emboli


Powder for injection: 250,000, 750,000, and 1.5 million international units/vial

Indications and dosages

Acute evolving transmural myocardial infarction

Adults: 1.5 million international units by I.V. infusion over 1 hour as soon as possible after symptom onset. For intracoronary infusion, 20,000 international units by I.V. bolus via coronary catheter, followed by infusion of 2,000 international units/minute over 1 hour (total of 140,000 international units).

Deep-vein thrombosis (DVT)

Adults: Loading dose of 250,000 international units by I.V. infusion over 30 minutes, followed by 100,000 international units/hour I.V. for 72 hours. Begin therapy as soon as possible after thrombotic symptoms begin (preferably within 7 days).

Pulmonary emboli

Adults: Loading dose of 250,000 international units by I.V. infusion over 30 minutes, then 100,000 international units/hour I.V. for 24 hours (or 72 hours if concurrent DVT is suspected). Begin therapy as soon as possible after thrombotic symptoms begin (preferably within 7 days).

Arterial thrombosis or emboli

Adults: Loading dose of 250,000 international units by I.V. infusion over 30 minutes, then 100,000 international units/hour I.V. for 24 to 72 hours. Begin therapy as soon as possible after thrombotic symptoms begin (preferably within 7 days).


• Hypersensitivity to drug or anistreplase

• Cerebrovascular accident, intracranial or intraspinal surgery within past 2 months

• Active internal bleeding

• Intracranial neoplasm

• Severe, uncontrolled hypertension


Use cautiously in:

• severe hepatic or renal disease, recent major surgery or trauma, obstetric delivery, acute pericarditis, infectious endocarditis, atrioventricular malformation or aneurysm, suspected thrombus in left side of heart, septic thrombophlebitis or occluded arteriovenous cannula at seriously infected site

• conditions in which bleeding may be hard to manage (such as organ biopsy, peptic ulcer, previous puncture of noncompressible blood vessel)

• history of cerebrovascular disease

• use of drug within past 2 years

• concurrent anticoagulant use

• elderly patients

• pregnant or breastfeeding patients.


Before giving, make sure hydrocortisone is available to treat allergic reaction and aminocaproic acid is available to treat excessive bleeding.

As ordered, give test dose of 100 international units intradermally to check for hypersensitivity. Wheal-and-flare response within 20 minutes indicates probable allergy.

• To reconstitute, add 5 ml of normal saline solution or dextrose 5% in water to each vial, then dilute again to 45 ml. Roll vial gently between hands; don't shake.

• If necessary, dilute further to 50 ml in plastic container or to 500 ml in glass bottle.

• Don't mix with other drugs or give other drugs through same I.V. line.

Adverse reactions

CNS: headache, intracranial hemorrhage

CV: hypotension, arrhythmias

EENT: periorbital swelling

GI: nausea, vomiting, GI hemorrhage

GU: hematuria

Hematologic: anemia, bleeding tendency

Musculoskeletal: musculoskeletal pain

Respiratory: minor breathing difficulties, bronchospasm, apnea

Skin: urticaria, itching, flushing

Other: bleeding at puncture sites, delayed hypersensitivity reaction


Drug-drug. Anticoagulants, aspirin, dipyridamole, indomethacin, phenylbutazone: increased risk of bleeding

Drug-diagnostic tests. Hemoglobin: decreased value

International Normalized Ratio, transaminases: increased values

Partial thromboplastin time (PTT), prothrombin time (PT): prolonged

Patient monitoring

• Monitor vital signs and neurologic status carefully after giving test dose and throughout therapy.

Watch for signs and symptoms of hypersensitivity reaction. Stop drug if these occur.

• Check for bleeding every 15 minutes for first hour, every 30 minutes for next 7 hours, then every 4 hours.

Stop therapy and contact prescriber immediately if excessive bleeding occurs.

• Assess neurologic status closely. Watch for indications of intracranial bleeding.

• Handle patient gently and sparingly. If necessary, pad bed rails to prevent injury.

• Monitor pulse rate every hour. Also monitor distal circulation.

• Monitor PTT, PT, plasma thrombin time, hemoglobin, hematocrit, and platelet count.

• Avoid giving I.M. injections during therapy.

Patient teaching

• Tell patient why he's receiving drug.

Teach patient to recognize and immediately report signs or symptoms of hypersensitivity reaction or excessive bleeding.

• Instruct patient to report unusual bruising or bleeding. Teach him safety measures to avoid bruising and bleeding.

• Advise patient that he'll undergo regular blood testing during therapy.

• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs and tests mentioned above.

McGraw-Hill Nurse's Drug Handbook, 7th Ed. Copyright © 2013 by The McGraw-Hill Companies, Inc. All rights reserved

strep·to·ki·nase (SK),

an extracellular protein produced by certain streptococci that binds to plasminogen and activates its conversion to plasmin; it has no enzyme activity of its own.
Farlex Partner Medical Dictionary © Farlex 2012


(strĕp′tō-kĭn′ās, -āz, -kī′nās, -nāz)
A protein, produced by hemolytic streptococci, that converts plasminogen to plasmin and is used as a drug to dissolve blood clots.
The American Heritage® Medical Dictionary Copyright © 2007, 2004 by Houghton Mifflin Company. Published by Houghton Mifflin Company. All rights reserved.


Kabikinase®, Streptase® Cardiology A fibrinolytic enzyme that converts plasminogen to plasmin, and used as a thrombolytic for reperfusing acutely occluded coronary arteries. See Thrombolytic therapy. Cf APSAC, tPA.
McGraw-Hill Concise Dictionary of Modern Medicine. © 2002 by The McGraw-Hill Companies, Inc.


(SK) (strep'tō-kī'nās)
An extracellular metalloenzyme from hemolytic streptococci that cleaves plasminogen, producing plasmin, which causes the liquefaction of fibrin; usually used in conjunction with streptodornase in the removal of clots.
Medical Dictionary for the Health Professions and Nursing © Farlex 2012


A protein-splitting ENZYME used as a drug to dissolve blood clot in a coronary artery so as to minimize the degree of MYOCARDIAL INFARCTION during a heart attack. It is also used to treat PULMONARY EMBOLISM. The drug is on the WHO official list. Brand names are Kabikinase and Streptase.
Collins Dictionary of Medicine © Robert M. Youngson 2004, 2005


Extracellular protein produced by some streptococci that binds to plasminogen and activates its conversion to plasmin; no enzyme activity of its own.
Medical Dictionary for the Dental Professions © Farlex 2012
References in periodicals archive ?
time from onset of cardiac pain to administration of streptokinase) in the study group was 6.32 [+ or -] 2.23 hours while as those in the control group was 4.90 [+ or -] 1.95 hours.
Isolation, production, purification, assay and characterization of fibrinolytic enzymes (nattokinase, streptokinase and urokinase) from bacterial sources.
The mean age of patients of reteplase group was 56.7 [+ or -] 4.95 years and for patients of streptokinase group was 53.2 [+ or -] 9.19 years (Table 3).
Here we report an antenatal case of aortic PVT, presenting in first trimester and thrombolysed with streptokinase.
The regular administration of steroids and antihistamines to prevent hypotension/bradycardia specially in association with Streptokinase complicates the administration procedures and is improbable to avert hypotension as the cause of Streptokinase induced hypotension is principally due to speed of administration [61, 62] and the exploit of bradykinin activated by Streptokinase [63].
Streptokinase is available in powder form for parenteral administration with 250,000, 750,000, or 1.5 million units per vial (, 2013a).
Streptokinase (SK) is a non-protease plasminogen activator, produced by certain streptococci and certain bacteria which contain appropriate genetic material derived from streptococci of Lancefield groups A, C or G.
We have performed the clinical trial to demonstrate efficacy and safety of IATT with streptokinase as a thrombolytic agent in ischemic stroke patients hospitalized at the Republican Research Center of Emergency Medicine (Tashkent, Uzbekistan).
Treatment of acute massive pulmonary embolism by streptokinase during labour and delivery.
The clotted samples were then treated with alteplase, urokinase, streptokinase, tenectoplase, or reteplase.