1. Streptokinase (DB00086) Approved Drug
Chemical Formula: C2100H3278N556O669S4
Molecular Weight:
Streptokinase, is a sterile, purified preparation of a bacterial protein elaborated by group C (beta) -hemolytic streptococci.
Indication/Usage
For the treatment of acute evolving transmural myocardial infarction, pulmonary embolism, deep vein thrombosis, arterial thrombosis or emolism and occlusion of arteriovenous cannulae
Pharmacodynamics
Streptokinase creates an active complex which promotes the cleavage of the Arg/Val bond in plasminogen to form the proteolytic enzyme plasmin. Plasmin in turn degrades the fibrin matrix of the thrombus, thereby exerting its thrombolytic action. This helps eliminate blood clots or arterial blockages that cause myocardial infarction
Mechanism of Action
Plasminogen is an inactive molecule that becomes activated to plasmin when the Arg/Val bond is cleaved. Plasmin breaks down fibrin clots created by the blood clotting cascade. Streptokinase forms a highly specific 1:1 enzymatic complex with plasminogen which converts inactive plasminogen molecules into active plasmin. Plasmin degrades fibrin clots as well as fibrinogen and other plasma proteins. This in turn leads to the degradation of blood clots.

2. Experimental Properties
Category
Fibrinolytic Agents and Thrombolytic Agents
Affected Organisms
Human and other Mammals
Drug Interactions
DB00208 (Ticlopidine): Increased bleeding risk. Monitor for signs of bleeding.
Sequence
MKNYLSFGMFALLFALTFGTVNSVQAIAGPEWLLDRPSVNNSQLVVSVAGTVEGTNQDISLKFFEIDLTSRPAHGGKTEQGLSPKSKPFATDSGAMSHKLEKADLLKAIQEQLIANVHSNDDYFEVIDFASDATITDRNGKVYFADKDGSVTLPTQPVQEFLLSGHVRVRPYKEKPIQNQAKSVDVEYTVQFTPLNPDDDFRPGLKDTKLLKTLAIGDTITSQELLAQAQSILNKNHPGYTIYERDSSIVTHDNDIFRTILPMDQEFTYRVKNREQAYRINKKSGLNEEINNTDLISEKYYVLKKGEKPYDPFDRSHLKLFTIKYVDVDTNELLKSEQLLTASERNLDFRDLYDPRDKAKLLYNNLDAFGIMDYTLTGKVEDNHDDTNRIITVYMGKRPEGENASYHLAYDKDRYTEEEREVYSYLRYTGTPIPDNPNDK
Experimental Properties
Hydrophobicity: 0.728
Isoelectric Point: 5.12
Targets
Plasminogen,Proteinase-activated receptor 1
Brands
Streptase – CSL Behring

3. STREPTASE Formulation Used/Prescribed for Dosage Contraindications
Streptase (Streptokinase)a bacterial protein elaborated by group C (beta) -hemolytic streptococci. It is sterile, purified preparation formulated as lypholized powder for intravenous or intracoronary administration
Formulation
25 mg cross-linked gelatin polypeptides, 25 mg sodium L-glutamate, sodium hydroxide to adjust pH, and 100 mg Albumin (Human) per vial or infusion bottle as stabilizers. The preparation contains no preservatives .
Used/Prescribed for
Indicated in Acute Evolving Transmural Myocardial Infarction, Pulmonary Embolism, Deep Vein Thrombosis, Arterial Thrombosis or Embolism, Occlusion of Arteriovenous Cannulae
Dosage
In Acute Evolving Transmural Myocardial Infarction,dose for IV-In 1,500,000 IU and IC-In 140,000 IU. For Pulmonary Embolism, Deep Vein Thrombosis, Arterial Thrombosis or Embolism, IV-In: 250,000 IU/30 min
Contraindications
No Information Provided.
Side- effects
Severe internal bleeding involving  gastrointestinal  (including hepaticbleeding), genitourinary, retroperitoneal, or intracerebral sites has occurred and has resulted in fatalities. Minor breathing difficulty to bronchospasm, periorbital swelling or angioneurotic edema have been observed rarely. Other milder allergic effects such as urticaria, itching, flushing, nausea, headache and musculoskeletal pain have also been observed, as have delayed hypersensitivity reactions such as vasculitis and interstitial nephritis, Respiratory depression, etc.

4. Drug Interactions References
Use of Anticoagulants and Antiplatelet Agents -- Streptase, Streptokinase, alone or in combination with antiplatelet agents and anticoagulants, may cause bleeding complications.- Continuous intravenous infusion of heparin, without a loading dose, has been recommended following termination of Streptase, Streptokinase, infusion for treatment of pulmonary embolism or deep vein thrombosis to prevent rethrombosis.
References