Types and Classification of Fibrinolytics

Fibrinolytics are drugs used to dissolve blood clots, thereby restoring normal blood flow in conditions like myocardial infarction, stroke, and deep vein thrombosis.

Classification of Fibrinolytics

Based on Mechanism of Action

• Plasminogen Activators: Convert plasminogen into plasmin, which degrades fibrin.
• Direct Fibrinolytics: Act directly on fibrin to dissolve clots.

Based on Source

• Recombinant: Genetically engineered variants like Alteplase.
• Non-Recombinant: Natural forms such as Streptokinase.

Commonly Used Fibrinolytics

• Alteplase: Recombinant tissue plasminogen activator (tPA).
• Reteplase: A modified form of tPA with longer half-life.
• Streptokinase: Bacterial-derived fibrinolytic agent.

Clinical Applications

Fibrinolytics are primarily used in emergency settings to treat conditions such as:

• Acute myocardial infarction (AMI)
• Ischemic stroke
• Deep vein thrombosis (DVT)
• Pulmonary embolism (PE)

Precautions and Contraindications

Despite their benefits, fibrinolytics pose risks of excessive bleeding and should be used cautiously in patients with:

• Recent surgery or trauma
• Active internal bleeding
• Hemorrhagic stroke
• Severe hypertension