All the Therapeutic System Drugs
Thrombolytic Agent. Alteplase 20 mg/vial, 50 mg/Vial. VIAL. (pwdr.+ solvent for sol. for inject./
infus.): 1 + 1 vial of solvent. Dosage
must be ajust. individ according to pt.
med. cond.
Acute MI: In adults for the lysis of thrombi
obstruct. coron. arteries, the reduction of
infarct size, the improve. of ventr. func., the
reduction of the incidence of congest.
heart fail., reduct. of mortality assoc. with
AMI. Tmt. should be initiated as soon as
possible after the onset of AMI sympt.
Acute Massive Pulmon. embol. with
hemodynamic deprivation.: Management
of acute massive pulmonary embolism
(PE) in adults: For the lysis of acute pulm.
emboli, defined as obstruct. of blood flow
to a lobe or multiple segments of the lung,
For the lysis of pulmon. emboli
accompanied by unstable hemodynamics
e.g. fail.to maintain blood pressure
without supportive measures.
The diagnosis should be confirmed by
objective means, such as pulmon.
angiography or noninvasive procedures
such as lung scanning.For fibrinolytic
treatment of acute ischaemic stroke Tmt.
must be started as early as possible within
4.5 hrs. after onset of stroke sympt.and
after exclusion of intracr. haemorrhage by
appropriate imaging techniques (e.g.
cranial CT or other diag. imaging method
sensitive for the presence of
haemorrhage). The tmt. effect is timedependent;
therefore earlier tmt. incr. the
probability of a favourable outcome.
C/I: Hypersens. High risk cases of
haemorrhage such e.g.: Signific. bleed.
disor. at present or within the past 6
mnths. Known haemorrhage.diathesis.
Pts. receiving effective oral anticoag.
tmt., e.g. warfarin sodium (INR>1.3). Manifest or recent severe or dangerous bleed. Known hist. of or suspected intracran.
haemorrhage. Suspected subarachnoid
haemorrhage/condition after subarachnoid haemorrhage from aneurysm. Any history of CNS damage (i.e. neoplasm, aneurysm, intracran./spinal surg.). Recent (less than 10 days) traumatic external heart massage,
obstetrical delivery, recent puncture of a
non-compressible blood-vessel (e.g.
subclavian or jugular vein puncture).
Severe uncontrol.arterial hypertens.
Bact. endocarditis, pericarditis. Acute
pancreatitis. Documented ulcerative GI
dis. during the last 3 mnths., oesophageal varices, arterial-aneurysm, arterial/venous malformations.
Neoplasm with incr. bleed.risk. Severe liver dis., includ. hep. fail., cirrhosis, portal hypertension (oesophageal varices) and active hepatitis. Major surg. or signific. trauma in past 3 mnths.
Addit. contraind. in acute massive pulmonary embolism, MI, acute ischaemic stroke: see lit.
Acute ischaemic stroke in child. under 16 yrs old.
Antiplatelet Agent. Tirofiban HCl Monohydrate 0.05 mg/ml. VIAL FOR INJECT: 1 x 12.5 mg/50 ml
(0.25 mg/ml).
INFUS. BAG: 1 x 12.5 mg/250 ml (0.05
mg/ml). Initial: 0.4 μg/kg/min of
diluted sol. by I.V. Then 0.1 μg/kg/min.
See lit.
In comb. with heparin in unstable
ang. or non-Q-wave M.I., prevent card.
ischem. events, acute coronary syndr.
(incl. medically managed and
undergoing PTCA or atherectomy). See
lit.
Thrombin Inhibitor. Bivalirudin 250 mg/vial. VIALS (pwdr. for I.V. inject.): 1 x 10. I.V.
bolus: 1.0 mg/kg foll. by 4 hr. infus. at
rate of 2.5 mg/kg/hr. Aft. complete
initial 4 hr. infus., addition. I.V. infus.
may be initiat. at 0.2 mg/kg/hr. for up
to 20 hrs. if reqd. Use with aspirin (300
- 325 mg dly). Initiate just prior to
PTCA. May need to reduce dose and
anticoag. status monitored in pts. with
ren. impair.
Unstable ang. undergoing percutan.
translum. coron. angioplasty (PTCA). To
be used with aspirin. See lit. for safety
and effectiveness.
C/I: Known hypersens.
Anticoagulant, Direct Factor Xa Inhibitor. Apixaban 2.5 mg, Apixaban 5 mg. FC tabs 2.5mg/5 mg X30
Prevent. of VTE (VTEp): elect. hip or knee replacem. surgery 2.5 mg taken orally 2Xd, initial dose to be taken 12 to 24 hs after surg. In ptts. undergoing hip replacem., tmt. is 32 to 38 days. In ptts. undergoing knee replacem., tmt. is 10 to 14 days. Prevent. of stroke and syst. embol. in ptts. with non-valv. atrial fibrill. (NVAF): 5 mg taken orally 2Xd. See full prescript. info.
for 2.5 mg: prevent. of venous thromboemb. events (VTE) in adlt. ptts. who have undergone elect. hip or knee replacem.
for both 2.5 and 5 mg: prevent. of stroke and syst. embol. in adlt. ptts. with non-valv. atrial fibrill. (NVAF), with one or more risk factors, such as prior stroke or transient isch. attack (TIA); age≥ 75 y; HT; diabetes mellitus; sympt. heart fail. (NYHA Class ≥ II). Tmt. of deep vein thromb.(DVT) and pulmon. embol. (PE), and prevent. of recurrent DVT and PE in adults.
C/I: Hypersens. Act. clin. signif. bleeding. • Hep. dis. assoc. with coagulopathy and clinic. relevant bleeding risk • Lesion or condit. posing a signif. risk factor for major bleeding, incl. current or recent GI ulcerat., presence of malign. neoplasms at high risk of bleeding, recent brain or spinal injury, recent brain, spinal or ophthalmic surg., recent intracran. haemorrhage, known or susp. oesophageal varices, arteriovenous malform., vasc. aneurysms or major intraspinal or intracerebral vasc. abnorm. • Concom. tmt. with any other anticoag. agent e.g. unfraction. heparin (UFH), low MW heparins (enoxaparin, dalteparin, etc.), heparin deriv. (fondaparinux, etc.), oral anticoag. (warfarin, rivaroxaban, dabigatran, etc.) except under spec. circumst. of switching anticoag. ther. or when UFH is given at doses necess. to maintain an open ctral. venous or arterial catheter.
Anticoagulant. Fondaparinux (sodium) 2.5 mg/0.5 ml, 0.75 mg/ 0.6 ml. PRE-FILLED SYR. (sol., for inject.): 10 x
0.5 ml x 2.5 mg, 10 x
0.6 ml x 0.75 mg. See lit.
Prevent. VTE in pts. undergoing major
orthoped. surg. lower limbs. Prevent. VTE in
pts. undergoing abdom. surg. who are at high risk thromboembol. complicats.
Prevent. VTE in medical pts. at high risk for
VTE and immobilised due to acute illness
such as card. insuffic. and/or acute respirat.
disords, and/or acute infects. or inflamm.
dis. Tmt. unstable angina or non-ST segm.
elevat. myocard. infarct. (UA/NSTEMI) in
pts. where urgent invas. manage. (PCI) not
indicat. Tmt. ST segm. elevat. myocard.
infarct. (STEMI) in pts managed with
thrombolytics or who are not to receive
other form reperfus. ther.
C/I: Hypersens., active clin. bleed., acute
bact. cardit., severe ren. fail. (creatinine
clear. <20 ml/min).
Salicylate. Acetylsalicylic Acid 500 mg. TABS: 20. 1-2 tabs. every 4-8 hrs., max.
6 tabs dly.
Pain, fever, antirheumat. tmt., inhibit.
platelet aggregat.
