Anistreplase

Pharmaceutical drug used to treat blood clots

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Anistreplase is a thrombolytic drug. It is also known as anisoylated plasminogen streptokinase activator complex (APSAC). As a thrombolytic drug, it is used to treat blood clots in emergency situations.

Uses

Anistreplase is used to treat blood clots in emergency situations such as myocardial infarction.^[1] Early treatment gives better outcomes.^[1]

Mechanism of action

Anistreplase is a complex of purified human plasminogen and bacterial streptokinase that has been acylated to protect the enzyme's active site. When the drug is administered, the acyl group gets hydrolyzed, thereby freeing the activator complex. It converts plasminogen to plasmin, which in turn degrades fibrin (blood clots) to fibrin split products.^{[citation needed]}

History

Anistreplase has been developed by Beecham under the brand name Eminase. It is also known as anisoylated plasminogen streptokinase activator complex (APSAC) after its components.^[1]^[2]^[3]

References

^ ^a ^b ^c Rawles J (27 January 1996). "Magnitude of benefit from earlier thrombolytic treatment in acute myocardial infarction: new evidence from Grampian region early anistreplase trial (GREAT)". British Medical Journal. 312 (7025): 212–5. doi:10.1136/bmj.312.7025.212. PMC 2350007. PMID 8563585.
^ Hannaford P, Vincent R, Ferry S, Hirsch S, Kay C (April 1995). "Assessment of the practicality and safety of thrombolysis with anistreplase given by general practitioners". Br J Gen Pract. 45 (393): 175–9. PMC 1239197. PMID 7612317.
^ Rawles J, Light J (October 1993). "Loss of quality adjusted days as a trial endpoint: effect of early thrombolytic treatment in suspected myocardial infarction. Grampion Region Early Anistreplase Trial (GREAT)". J Epidemiol Community Health. 47 (5): 377–381. doi:10.1136/jech.47.5.377. PMC 1059832. PMID 8289038.

Antithrombotics (thrombolytics, anticoagulants and antiplatelet drugs) (B01)

Antiplatelet drugs

Glycoprotein IIb/IIIa inhibitors	Abciximab Eptifibatide Orbofiban Roxifiban Sibrafiban^§ Tirofiban
ADP receptor/P2Y₁₂ inhibitors	Thienopyridines Clopidogrel Prasugrel Ticlopidine Nucleotide/nucleoside analogs Cangrelor Elinogrel Ticagrelor
Prostaglandin analogue (PGI2)	Beraprost Iloprost Prostacyclin Treprostinil
COX inhibitors	Acetylsalicylic acid/Aspirin^# Aloxiprin Carbasalate calcium Indobufen Triflusal
Thromboxane inhibitors	Thromboxane synthase inhibitors Dipyridamole (+ aspirin) Picotamide Terbogrel Receptor antagonists Terbogrel Terutroban^§
Phosphodiesterase inhibitors	Cilostazol Dipyridamole Triflusal
Other	Cloricromen Ditazole Vorapaxar

Anticoagulants

Vitamin K antagonists
(inhibit II, VII, IX, X)

Factor Xa inhibitors
(with some II inhibition)

Heparin group/ glycosaminoglycans/ (bind antithrombin)	Low-molecular-weight heparin Bemiparin Certoparin Dalteparin Enoxaparin Nadroparin Parnaparin Reviparin Tinzaparin Oligosaccharides Fondaparinux Idraparinux^§ Heparinoids Danaparoid Dermatan sulfate Sulodexide
Direct Xa inhibitors ("xabans")	Apixaban Betrixaban Darexaban^§ Edoxaban Otamixaban^§ Rivaroxaban