Which of the following is used for treatment of bleeding secondary due to thrombolytic therapy?

Ans. C. EACA. (Ref Q. 179 of MH'2006 Paper; Harrison 18th/ch.l16).ThrombolyticsAlteplase (tPA), reteplase (rPA), tenecteplase (TNK-tPA).MechanismDirectly or indirectly aid conversion of plasminogen to plasmin, which cleaves thrombin and fibrin clots. PT, PTT, no change in platelet count.UsesEarly Ml, early ischemic stroke, direct thrombolysis of severe Pulm Embolism.ToxicityBleeding. Contraindicated in patients with active bleeding, history of intracranial bleeding, recent surgery, known bleeding diatheses, or severe hypertension. Treat toxicity with aminocaproic acid (EACA), an inhibitor of fibrinolysis. Fresh frozen plasma and cryoprecipitate can also be used to correct factor deficienciesIn VON WILLEBRAND DISEASE, HEMOPHILIA Antifibrinolytic therapy using either EACA or tranexamic acid is an important therapy, either alone or in an adjunctive capacity, particularly for the prevention or treatment of mucosal bleeding. These agents are particularly useful in prophylaxis for dental procedures, with DDAVP for dental extractions and tonsillectomy, menorrhagia, and prostate procedures. It is contraindicated in the setting of upper urinary tract bleeding, due to the risk of ureteral obstruction. In Inherited Disorders of Platelet Dysfunction, Particularly for mucosal bleeding symptoms, antifibrinolytic therapy (epsilon- aminocaproic acid or tranexamic acid) is used alone or in conjunction with DDAVP or platelet therapy.