Which medications in the drug class Antifibrinolytic Agents are used in the treatment of Budd-Chiari Syndrome?

Updated: Oct 10, 2018
  • Author: Praveen K Roy, MD, AGAF; Chief Editor: BS Anand, MD  more...
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Answer

Antifibrinolytic Agents

Fibrinolytic drugs are used to dissolve a pathologic intraluminal thrombus or embolus that has not been dissolved by the endogenous fibrinolytic system. They are also used for the prevention of recurrent thrombus formation and for the rapid restoration of hemodynamic disturbances.

Urokinase

Urokinase is a direct plasminogen activator that acts on the endogenous fibrinolytic system and converts plasminogen to the enzyme plasmin, which, in turn, degrades fibrin clots, fibrinogen, and other plasma proteins. It is most often used for local fibrinolysis of thrombosed catheters and superficial vessels. An advantage to this agent is that it is nonantigenic. However, urokinase is more expensive than streptokinase, limiting its use. When it is used for local fibrinolysis, urokinase is administered as a local infusion directly into the area of the thrombus, with no bolus given. The dose should be adjusted to achieve clot lysis or patency of the affected vessel.

Alteplase (Activase)

Alteplase is a tissue plasminogen activator used in the management of acute myocardial infarction, acute ischemic stroke, and pulmonary embolism. Its safety and efficacy with concomitant administration of heparin or aspirin during the first 24 hours after symptom onset have not been investigated.


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