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Thrombolytics.

C L Ostrow

    AACN Clinical Issues in Critical Care Nursing
    |May 1, 1992
    PubMed
    Summary
    This summary is machine-generated.

    Thrombolytic therapy significantly reduces mortality and improves heart function in acute myocardial infarction patients. This treatment, using agents like streptokinase, requires careful monitoring for bleeding complications.

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    Area of Science:

    • Cardiology
    • Pharmacology

    Background:

    • Thrombolytic therapy represents a major advancement in treating acute myocardial infarction (AMI).
    • Numerous global trials confirm its benefits, including a 50% mortality reduction, decreased infarct size, improved left ventricular function, and reduced heart failure incidence/severity.

    Purpose of the Study:

    • To review the efficacy and nursing considerations of thrombolytic therapy in acute myocardial infarction.
    • To compare the most common thrombolytic agents: streptokinase, tissue plasminogen activator (tPA), and anisoylated plasminogen-streptokinase activator complex (APSAC).

    Main Methods:

    • Review of recent research trials and clinical guidelines on thrombolytic therapy for AMI.
    • Assessment of patient contraindications, potential complications (bleeding, allergic reactions), and reperfusion markers.

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  • Evaluation of post-therapy management with anticoagulants and antiplatelet agents.

    • Main Results:

    • Streptokinase, tPA, and APSAC demonstrate similar 5-week mortality efficacy when administered intravenously.
    • Bleeding complications are the most serious adverse event associated with thrombolytic therapy.
    • Nursing care is crucial for patient assessment, monitoring, and management of potential complications.

    Conclusions:

    • Thrombolytic therapy is a highly effective treatment for acute myocardial infarction, with comparable efficacy among major agents.
    • Increased availability of thrombolytic therapy is anticipated, though current US access lags behind Europe.
    • Vigilant nursing assessment and management are essential for optimizing patient outcomes and minimizing risks.