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Mode of action of thrombolytics

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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All thrombolytics in use act as plasminogen activators:

  • plasminogen is the inactive precursor of plasmin
  • plasminogen and its natural activator, tPA, both bind to fibrin clots resulting in a cascade of local plasmin production
  • streptokinase activates plasminogen throughout the circulation
  • plasmin is a serine protease which is able to degrade fibrin, yielding soluble fibrin degradation products

Thrombolytics act at three sites:

  • thrombus
  • haemostatic plugs
  • streptokinase produces a systemic impairment of haemostasis

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