Thrombolytic agents are able to dissolve preformed arterial and venous thrombi and emboli and restore blood flow to anoxic tissue. Currently available thrombolytics are listed in T§bJe...2.11-9. These products work by inducing a systemic fibrinolytic state. This fibrinolytic state is not limited to the thrombus; it occurs throughout the circulation. This results in the potential for major hemorrhagic complications, which occur in about 9 percent of patients treated with thrombolytics compared with an average of 4 percent significant bleeding complications in patients treated with heparin. Because of this risk, the diagnosis of thrombus or embolus should be firmly established before treatment begins. Although theoretically more thrombus specific, major and minor bleeding complications are as common with recombinant tissue plasminogen activator (r-tPA) as with streptokinase.



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