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STREPTOKINASE KARMA is a brand name for Streptokinase. The medicine, its uses, side effects and dosage are the same regardless of brand.
Used for: Streptokinase Karma is indicated in adults. Streptokinase Karma is a fibrinolytic agent which may be used for the intravascular dissolution of thrombi and emboli in: - acute massive pulmonary embolism - acute, sub-acute or chronic (not older than 6 weeks) occlusion of peripheral arteries - extensive deep vein…
Verbatim from this product's MHRA label. Tap a section to expand.
Posology Adults Deep vein thrombosis An initial dose of 250 000 IU streptokinase should be infused into a peripheral vein over 30 minutes. A maintenance infusion of 100 000 IU/hour for 72 hours should follow. Pulmonary embolism Infuse 1 500 000 IU streptokinase into a peripheral vein preferably over a short time of 1-2 hours.
As an alternative, an initial dose of 250 000 IU streptokinase should be infused into a peripheral vein over 30 minutes. A maintenance infusion of 100 000 IU/hour for 24 hours should follow. Occlusive peripheral arterial diseases Administer streptokinase with a local intra-arterial catheter-directed infusion using one of the following regimes: - Gradual infusion: 1000 to 2500 IU streptokinase at an interval of 3 to 5 minutes for a maximum of 10 hours and a total maximum dose of 250 000 IU - Prolonged continuous low-dose infusion (using an infusion pump): 5000 to 10,000 IU streptokinase per hour for up to 5 days maximum.
A percutaneous transluminal angioplasty can be performed simultaneously, if necessary. As an alternative for difficult arterial access or multiple occlusions, an initial dose of 250 000 IU streptokinase should be infused over 30 minutes.
A maintenance infusion of 100 000 IU/hour for a maximum of 5 days should follow. Central retinal vessel occlusion An initial dose of 250 000 IU streptokinase should be infused into a peripheral vein over 30 minutes. A maintenance infusion of 100 000 IU/hour for 12 hours should follow.
Paediatric population The safety and efficacy of Streptokinase Karma have not been sufficiently established in children. Due to low levels of plasminogen in newborns and in children with acquired plasminogen deficiency and due to the potential of streptokinase for allergic/anaphylactic reactions, it is not recommended in neonates, infants and children.
Control of Therapy Before commencing thrombolytic therapy, it is desirable to obtain a thrombin time (TT), activated partial thromboplastin time (aPTT), haematocrit and platelet count to obtain the haemostatic status of the patient.
If heparin has been given it should be discontinued, and the TT or aPTT should be less than twice the normal control value before the thrombolytic therapy is started. 3 before starting therapy with streptokinase. Method of Administration The administration of streptokinase may be by systemic intravenous infusion or by local intra-arterial catheter-directed infusion.
The following adverse reactions are based on clinical trial and post-marketing experience.
The following standard categories are used:
Very common more than1/10 Common more than 1/100; less than 1/10 Uncommon more than 1/1000; less than 1/100 Rare more than 1/10,000; less than 1/1000 Very Rare less than1/10,000 (including isolated cases) Blood and lymphatic system disorders Common: haemorrhage at the injection site, ecchymoses, gastrointestinal bleeding, genitourinary bleeding, epistaxis Uncommon: cerebral haemorrhages with their complications and possible fatal outcome, retinal haemorrhages, severe haemorrhages (also with fatal outcome), liver haemorrhages, retroperitoneal bleeding, bleeding into joints, splenic rupture.
Blood transfusions are rarely required. , aprotinin, should be given as follows. Initially 500 000 KIU (Kallikrein Inactivator Unit) up to one million KIU by slow intravenous injection or infusion. If necessary this should be followed by 200,000 KIU every four hours by intravenous drip until the bleeding stops.
In addition, combination with synthetic antifibrinolytics is recommended. If necessary, clotting factors can be substituted. Additional administration of synthetic antifibrinolytics has been reported to be efficient in single cases of bleeding episodes.
g. g. g. Guillain Barré syndrome), severe allergic reactions up to shock including respiratory arrest. Moderate or mild allergic reactions can be managed with concomitant antihistamine and/or corticosteroid therapy. If a severe allergic reaction occurs the infusion of streptokinase should be discontinued immediately and the patient given the appropriate treatment.
The current medical standards for shock treatment should be observed. g. dizziness, confusion, paralysis, hemiparesis, agitation, convulsion) in the context of cerebral haemorrhages or cardiovascular disorders with hypoperfusion of the brain Eye disorders Very rare: iritis/uveitis/iridocyclitis Cardiac and vascular disorders Common: at the start of therapy, hypotension, tachycardia, bradycardia Very rare: crystal cholesterol embolism During fibrinolytic therapy with streptokinase in patients with myocardial infarction, the following events have been reported as complications of myocardial infarction and/or symptoms of reperfusion: Very common: hypotension, heart rate and rhythm disorders, angina pectoris Common: recurrent ischaemia, heart failure, reinfarction, cardiogenic shock, pericarditis, pulmonary oedema Uncommon: cardiac arrest (leading to respiratory arrest), mitral insufficiency, pericardial effusion, cardiac tamponade, myocardial rupture, pulmonary or peripheral embolism These cardiovascular complications can be life-threatening and may lead to death.
1. 3) - severe liver or kidney damage - endocarditis or pericarditis. g. recent organ biopsy, long-term (traumatic) closed chest cardiac massage
1. 3) - severe liver or kidney damage - endocarditis or pericarditis. g. recent organ biopsy, long-term (traumatic) closed chest cardiac massage
Not medical advice. Always read the patient information leaflet and follow your prescriber or pharmacist.
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6. Upon reconstitution with physiological saline a clear solution, colourless to yellowish, is obtained. 8). Systemic Administration During the infusion, decreases in the plasminogen and fibrinogen levels and an increase in the level of fibrin degradation product (FDP) (the latter two serving to prolong the clotting time of coagulation tests) will generally confirm the existence of a thrombolytic state.
Therefore, therapy can be monitored by performing the TT or aPTT approximately 4 hours after initiation of therapy. A 2 to 4 fold prolongation of the TT should be aimed for and is considered a sufficient anticoagulation protection. 5 times the normal control value, discontinue Streptokinase Karma as excessive resistance to streptokinase is present.
Local administration As is usual with angiographies, heparin is administered, if necessary, prior to the angiography as a safeguard against catheter-induced thromboses. The success of therapy can be determined by the angiography. With a sufficient blood flow of more than 15 minutes the therapy can be considered successful and then stopped.
Follow-up treatment After every course of streptokinase therapy, follow-up treatment with anticoagulants or platelet aggregation inhibitors can be instituted as prevention of rethromboses. With heparin therapy, in particularly, an increased risk of haemorrhage must be considered.
During local lysis of peripheral arteries, distal embolization cannot be excluded. Respiratory Disorders Very rare: non-cardiogenic pulmonary oedema after intracoronary thrombolytic therapy in patients with extensive myocardial infarction Gastrointestinal disorders Common: nausea, diarrhoea, epigastric pain, vomiting General disorders and administration site conditions Common: headache, back pain, musculoskeletal pain, chills, fever, asthenia, malaise Testing Common: Transient elevations of serum transaminases and bilirubin Reporting of suspected adverse reactions Reporting suspected adverse reactions after authorisation of the medicinal product is important.
It allows continued monitoring of the benefit/risk balance of the medicinal product. uk/yellowcard.