Sunday, 7 May 2017

Drug Interactions of Fibrinolytics (Part 2):


Drug Interactions of Streptokinase:



More presntations from Naina Mohamed, PhD

©   Streptokinase is a Fibrinolytic agent and it is isolated and purified from streptococci bacteria.

©   Our body develops an immunity to Streptokinase, since it is a bacterial product.  Hence, it is not recommended to use Streptokinase again after four days from the first administration. Further thrombotic events could be treated with Recombinant Tissue Plasminogen Activators (rtPA) such as Alteplase, Reteplase and Tenecteplase.

©   Streptokinase is used in Acute Myocardial Infarction, Arterial and Venous Thrombosis and Pulmonary Embolism.

©   Due to the lack of fibrin specificity of Streptokinase, it produces more fibrinogenolysis which makes it a less desirable thrombolytic drug than rtPA compounds.

©   Overdose of Streptokinase or rtPA can be treated with Aminocaproic acid.

©   Concurrent use of Streptokinase and Antiplatelet agents such as Aspirin, Dipyridamole and Clopidogrel  results in elevated risk of Bleeding.

©   It is Contraindicated to use Fibrinolytics and Defibrotide concomitantly.

©   Drugs increasing the risk of Fibrinolytics associated Bleeding include…

o  Anticoagulants (Warfarin, Heparin, Enoxaparin, Dabigatran, etc)

o  Antiplatelet agents (Aspirin, Clopidogrel, etc)

o  Pentosan Polysulfate Sodium


©   Herbs increasing the risk of Fibrinolytics associated Bleeding include…

o  Fenugreek

o  Garlic

o  Ginkgo

o  Evening Primrose Oil

o  Clove Oil

o  Anise

o  Turmeric (Curcumin)

o  Licorice

o  Asafetida

o  Capsicum (Capsaicin)

o  Celery

o  Kava

o  Cat's claw

o  Medowsweet

o  Feverfew

o  Tan-shen

©   Drug interactions can result in significant morbidity and mortality and thus minimizing the risk for drug interactions should be a goal in drug therapy.

©   The risk of adverse effects could be reduced by healthcare professionals through the screening, education, and follow up on suspected drug interactions.

©   Pharmacists can play a crucial role in identifying possible drug interactions by asking patients on Anticoagulants about their herbal and other alternative medicine product use.



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Drug Interactions of Thiazide Diuretics:

https://www.researchgate.net/publication/342864519_Pharmacodynamic_interactions_of_thiazide_diuretics http://www.ijmdc.com/?mno=51031...