Pharmacology Effectiveness of streptokinase in Acute Miocardial Research Paper

Pharmacology Effectiveness of streptokinase in Acute Miocardial Infarction - Research Paper Example The administration of aspirin and heparin before the treatment will increase the survival rate. Introduction: Acute myocardial infraction is the breakdown of the heart muscles due to the lack of oxygen supply. The shortage in oxygen supply is caused by the collection of lipids at the heart muscles. This creates a block in the blood vessels resulting in ischemia and if left untreated it results in infraction of the myocardial cells. The risk factors of acute myocardial infarction (AMI) are cardiovascular disease, tobacco smoking, older age, kidney diseases, blood pressure, excessive alcohol consumption and obesity. Streptokinase is one of the first thrombolytic agent to be used for the treatment of Acute myocardial infarction. Streptokinase was discovered in the year 1933 by Dr. William Smith Tillett. The use of Streptokinase for the treatment of acute myocardial infarction started in the year 1947 when Sol Sherry identified the potential of streptokinase. (Sikri and Bardia, 2007).The clinical trials using streptokinase started thereafter. They concluded that streptokinase can be used to treat hemothorax, purulent and sanguineous pleural exudations, fibrinous and tuberculosis meningitis. (Sikri and Bardia, 2007).The difficulties in purifying the protein streptokinase led to the delay in the intravenous use. The intravenous use of streptokinase was started in the year 1952. This proved to be a promising approach. ... Streptokinase binds to the circulating plasminogen and forms a complex. This complex activates the plasminogen through a three step mechanism. If fibrin is present, then the streptokinase – plasmin complex forming capacity gets increased and thus lyses the clots. (Becker, 1997). After infusion of the clot, the streptokinase spreads through the plasma. There are two phases of streptokinase clearance. The half life of first phase streptokinase is 11-17 minutes and that of the second phase is 85 minutes. The current recommended dose level of streptokinase is 1.5 million units for 30- 60 minutes. (Becker, 1997). The main drawback of streptokinase is that it is antigenic. The administration of streptokinase produces antibodies in the blood. The antibodies formed may neutralize the drug. (Becker, 1997). Development: After the discovery of Streptokinase in the year 1933, the mechanisms of action of streptokinase in humans were determined. In 1959, Ruegsegger discovered the intracoron ary clots. Many clinical trials were conducted at this time. There was a small risk of allergy. Many investigators considered this to be the plausible option for the treatment of acute myocardial infraction. In the year 1985 many small trials were conducted to standardize the protocol for streptokinase but no trial produced positive result. Finally they concluded that when the drug was administered for 1.5 to 3 hours, they were able to receive reperfusion rate of 90%. (Sikri and Bardia, 2007). GISSI Trial: Gruppo Italiano per la Sperimentazione della Streptochinasi nell'Infarto Miocardico ( GISSI) trial was conducted as the large scale trial. 11806 patients were enrolled in the study for a period of 17 months in 176 coronary heart care centre. New patients were recruited at a rate of