Trade Names:Eminase- Powder for injection, lyophilized 30 units (potency is expressed in units of anistreplase by using a reference standard that is specific for anistreplase and is not comparable with units used for other fribrinolytics)
Aids in dissolution of blood clots.
Deacylation of anistreplase forms lys-plasminogen-streptokinase activator complex (active).
T ½ of fibrolytic activity is approximately 94 min.
Lysis of obstructing coronary thrombi for management of acute MI.
Hypersensitivity to streptokinase; active internal bleeding; history of cerebrovascular accident; recent (within 2 mo) intracranial or intraspinal surgery or trauma; intracranial neoplasm; arteriovenous malformation or aneurysm; known bleeding diathesis; uncontrolled hypertension.
IV 30 units over 2 to 5 min into IV line or vein. Reconstitute powder with 5 mL of sterile water for injection. Do not shake vial during reconstitution; try to minimize foaming. Do not further dilute reconstituted anistreplase.
Store lyophilized anistreplase under refrigeration. Discard any reconstituted anistreplase not administered within 30 min of reconstitution.
May increase risk of bleeding.
Do not add to any infusion fluids. Do not add other medications to vial or syringe containing anistreplase.
Can cause decreases in plasminogen and fibrinogen levels and increases in thrombin time, activated PTT and PT, making results of coagulation tests unreliable.
Arrhythmia and conduction disorders; hypotension.
Bleeding at puncture site, nonpuncture-site hematoma; hematuria; hemoptysis; GI hemorrhage; intracranial bleeding; mouth and gum hemorrhage; epistaxis; ocular hemorrhage; nonspecific hemorrhage.
Monitor diligently for signs or symptoms of internal or surface bleeding. Remember that lab values for coagulation tests and measurements of fibrinolytic activity after anistreplase therapy may be unreliable.
Category C .
Safety and efficacy not established.
Rarely, anaphylactic and anaphylactoid reactions (with bronchospasm or angioedema) may occur.
If arterial puncture is necessary after administration of anistreplase, it is preferable to use upper extremity vessel that is accessible to manual compression. Apply pressure dressing; check puncture site frequently for evidence of bleeding. Control minor bleeding with manual pressure.
Have epinephrine and emergency treatment provisions available during administration of anistreplase.
Because of formation of antistreptokinase antibody, anistreplase may not be effective if administered more than 5 day to 6 mo after prior anistreplase or streptokinase therapy or after streptococcal infection.