Complications of streptokinase are -

Ref: R. Alagappan Manual for Medicine 4th Edition pg no:188-189 Thrombolytic agents for Myocardial Infarction Agents with fibrin specificity: 1. Alteplase (-PA) 15 mg IV bolus followed by 0.75 mg/kg IV infusion (upto 50 mg) over 30 minutes then 0.5 mg/kg (upto 35 mg) by IV infusion over 60 minutes (maximum dose 100 mg IV over 90 minutes) 2. Reteplase (r-PA) 10 mg IV bolus over 2 minutes followed by another 10 mg IV bolus after 30 minutes. 3. Tenecteplase (TNK-tPA) 0.5 mg/kg IV bolus (<60 kg-30 mg, 61-70 kg -35 mg, 71-80 kg-40 mg, 81-90 kg- 45 mg, >90 kg-50 mg) Agents without fibrin specificity: 1. Streptokinase - 1.5 million units IV infusion over 60 minutes 2. Urokinase Because of the development of antibodies, patients who were previously treated with strepto- kinase should be given an alternate thrombolytic agent. Contraindications for Thrombolytic Therapy Absolute contraindications: Active bleeding Defective haemostasis Recent major trauma Surgical procedures < 10 days Invasive procedures < 10 days Neurosurgical procedure < 2 months GI/genito-urinary bleeding < 6 months Stroke/TIA < 12 months Prolonged CPR > 10 minutes H/O CNS tumour, aneurysm, AV malformation Active peptic ulcer Aoic dissection Acute pericarditis Active inflammatory bowel disease Active cavitary lung disease Pregnancy Relative contraindications: Systolic BP > 180 mm Hg Diastolic BP >110 mm Hg Bacterial endocarditis Haemorrhagic diabetic retinopathy H/O intraocular bleeding Chronic warfarin therapy Severe renal or liver disease Severe menstrual bleeding