Mitral stenosis associated with AF. Streptokinase treatment within last 12 mth, use after prolonged or traumatic CPR; diabetic retinopathy. Elderly. Because of the increased likelihood of resistance, due to antistreptokinase antibodies, retreatment with Streptokinase or Streptokinase-containing products may not be effective if administered between five days and twelve months of prior Streptokinase administration or Streptococcal infections, such as Streptococcal pharyngitis, acute rheumatic fever or acute glomerulonephritis secondary to a Streptococcal infection. In principle, no thrombolytic treatment should be commenced before the 10th postoperative day. However, in cases of pulmonary embolism, the indication for earlier treatment may be very strong and after careful consideration of all the risks, Streptokinase may be given before the tenth postoperative day. The danger of bleeding from the operative area must, of course, be taken into account. The danger of haemorrhage is increased by simultaneous or previous treatment with anticoagulants (e.g., Heparin) or substances which inhibit platelet formation or function. If the patient is under active he
Adult: IV infusion: Acute MI: 1.5 million u as a single dose immediately after onset of symptoms.
Total solution volume 45 ml. Infusion rate: Infuse 45 ml within 60 mins.
Pulmonary thromboembolism; Deep Vein Thrombosis, Arteriovenous occlusions Loading dose: 250,000 u via infusion.
Total solution volume 90 ml, Infusion rate: Infuse 30 ml/hour for 30 min. Maintenance: 100,000 u/hr for 24-72 hr depending on the condition treated. Duration for cerebral retinal thrombosis: 12 hr. Maintain thrombin clotting time at 2-4 times normal values.
Child: Loading dose: 2500-4000 units/kg over 30 min, followed by infusion of 500-1000 units/kg/hr, continued until reperfusion occurs, up to 3 days. Initial dose may be estimated by streptokinase resistance test. Monitor treatment by maintaining thrombin clotting time at 2-4 times normal values.