Dose of streptokinase to be used in Ml is ?
Correct Answer: 1.5 Million units
Description: Ans. is 'b' i.e., 1.5 Million units o The adult dose of streptokinase for Acute Myocardial Infarction is 1.5 million UIV over 60 minutes. (Given in 50 ml of 5% dextrose in water -D5 W)Preferred thrombolytic regimens for acute ST elevation mvocardial infarctionDrugRecommended IV regimensAdvantages and LimitationsAlteplase(acceleratedregimin15 mg bolus- Then 0.75 mg/kg (maximum 50 mg) over 30 minutes- Then 0.5 mg/kg (maximum 35 mg over the next 60 minutes)Better outcomes than streptokinase in GUSTO-1 (30-Day mortality? 6.3 versus 7.3 percent); costlier than streptokinase more difficult to administer because of short half-life.TenecteplaseSingle bolus over five to ten seconds based upon body weight- < 60 kg: 30mg- 60 to 69 kg: 35 mg- 70 to 79 Kg : 40 mg- 80 to 89 kg : 45 mg- > 90 kg : 50 mgAs effective as alteplase in ASSENT-2 with less noncerebral bleeding and need for transfusion; easier to admins is ter (single bolus due to longer half- life) both in and out of hospital; these advantages make tenecteplase the drug of choice in many US. hospitalsReteplase10 units over two minutes then repeat10 unit bolus at 30 minutesSimlar outcomes as alteplase but easier to administerStreptokinase1.5 million units over 30 to 60 minutesGenerally a much less costly option than other fibrinolytics but outcomes are inferior. Neutralizing antibodies develop, which can diminish efficacy of subsequent use. Elevated risk of hypersensitivity reaction with repeated doses. Used extensively outside North America due to lower cost.(Not available in US or CAN).
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