Urokinase
Anticoagulant/Antiplatelet · Fibrinolytic
Indications
To maintain patency of thrombosed intravascular catheters and cannulae, deep vein thrombosis, pulmonary embolism, peripheral vascular occlusion.
Dosage
Deep vein thrombosis: By IV infusion, initially 4400 units/kg in 15 mL sodium chloride 0.9% over 10 min, followed by 4400 units/kg/hr for 12-24 hr. Pulmonary embolism: By IV infusion, initially 4400 units/kg in 15 mL sodium chloride 0.9% over 10 min, followed by 4400 units/kg/hr for 12 hr or by injection into pulmonary artery, initially 15000 units/kg subsequent doses adjusted according to response; max 3 doses in 24 hr. Occluded catheters and cannulas: By injection directly into catheter or cannula, 5000-25000 units dissolved in suitable volume of sodium chloride 0.9% to fill the catheter or cannula lumen; leave for 20-60 min then aspirate the lysate, repeat if necessary. Peripheral vascular occlusion: See literature.
Administration
Administer using a pump which can deliver a total volume of 195 mL. The loading dose should be administered at 90 mL/hour over 10 min. The maintenance dose is 15 mL/hour over 12 hours. Compatibility: Stable in NS or D5W.
Adverse Effects
Local irritation, bleeding and haemorrhagic complications, pyrexia, haematuria, embolic episodes, cholesterol embolism, allergic reactions.
Risk Factor (Pregnancy/Lactation)
Pregnancy: Contraindicated in pregnancy. Lactation: Caution advised or effect undetermined. Contraindications: Recent bleeding following surgery, cerebrovascular bleeding, severe hypertension, severe hepatic or renal impairment, immediate postpartum period. Precautions: Peptic ulcer or risk of GI bleeding, recent repeated intravascular or intracardiac puncture, recent cardiopulmonary resuscitation.
Advice to Patient
Contact prescriber if there is chest pain; palpitations; irregular heartbeat; unusual bruising or bleeding; muscle pain; redness, swelling, oozing at infusion site; acute headache; joint pain; vision changes or respiratory difficulty. To prevent bleeding, use soft toothbrush, floss with waxed floss, use electric razor, avoid scissors or sharp knives and harmful activities. Take strict bed rest to avoid injury. If bleeding occurs, report immediately and apply pressure to bleeding spot until bleeding stops completely.
Pharmacokinetics
Onset: Immediate. Duration: 4 hrs. Metabolism: Hepatic. Half-life elimination: 12 mins. Time to peak, plasma: 20 mins-4 hrs. Excretion: Bile. Urine.
Brands with this active ingredient
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