Streptokinase vs. Urokinase

Attribute	Streptokinase	Urokinase
Origin	Bacterial	Human
Type	Enzyme	Enzyme
Source	Streptococcus bacteria	Human kidney cells
Function	Dissolves blood clots	Dissolves blood clots
Administration	Injected	Injected
Medical Uses	Treatment of heart attacks, pulmonary embolism, deep vein thrombosis	Treatment of heart attacks, pulmonary embolism, deep vein thrombosis
Side Effects	Bleeding, allergic reactions	Bleeding, allergic reactions

Introduction

Streptokinase and Urokinase are both thrombolytic agents used in the treatment of blood clot-related conditions. While they share the common goal of dissolving blood clots, these two drugs differ in their mechanisms of action, sources, administration routes, and side effects. Understanding the attributes of Streptokinase and Urokinase is crucial for healthcare professionals to make informed decisions regarding their use in clinical practice.

Mechanism of Action

Streptokinase is a non-enzymatic protein derived from streptococcal bacteria. It works by activating plasminogen, a precursor to plasmin, which is an enzyme responsible for breaking down fibrin clots. Once activated, plasmin degrades fibrin, leading to clot dissolution. On the other hand, Urokinase is a naturally occurring enzyme produced by the kidneys. It directly converts plasminogen to plasmin, bypassing the need for activation. This key difference in their mechanisms of action influences their efficacy and potential side effects.

Source

Streptokinase is derived from beta-hemolytic streptococci bacteria, specifically Streptococcus pyogenes. It is produced through a fermentation process and purified for therapeutic use. In contrast, Urokinase is a human enzyme that is naturally present in the urine. It can also be obtained through recombinant DNA technology, where it is produced using genetically engineered mammalian cells. The source of these drugs affects their availability, cost, and potential for allergic reactions.

Administration Routes

Streptokinase is primarily administered intravenously, either as a bolus injection or through continuous infusion. The dosage and duration of administration depend on the specific condition being treated. Urokinase, on the other hand, can be administered intravenously, intra-arterially, or even directly into the affected body cavity, such as the pleural space or joint. The choice of administration route depends on the location and severity of the clot, as well as the healthcare provider's preference and expertise.

Indications

Both Streptokinase and Urokinase are indicated for the treatment of acute myocardial infarction (heart attack), deep vein thrombosis (DVT), pulmonary embolism (PE), and arterial thrombosis. However, Streptokinase is also used in the management of occluded central venous catheters and peripheral arterial occlusion. Urokinase, on the other hand, has additional indications in the treatment of acute ischemic stroke and clearance of occluded arteriovenous shunts.

Side Effects

Streptokinase carries a higher risk of allergic reactions compared to Urokinase. This is due to its bacterial origin, which can trigger an immune response in some individuals. Allergic reactions may range from mild symptoms like rash and fever to severe anaphylaxis. Urokinase, being a human enzyme, is generally better tolerated and has a lower risk of allergic reactions. However, both drugs can cause bleeding complications, including gastrointestinal bleeding, intracranial hemorrhage, and bleeding at the injection site. Close monitoring of patients receiving these medications is essential to detect and manage any adverse effects promptly.

Contraindications

Streptokinase is contraindicated in patients with a history of streptococcal infection, active bleeding, recent surgery, or known hypersensitivity to the drug. Urokinase, on the other hand, should be avoided in patients with active bleeding, recent trauma or surgery, uncontrolled hypertension, or known hypersensitivity to the drug. Additionally, both drugs should be used with caution in patients with a history of stroke, peptic ulcer disease, or any condition that increases the risk of bleeding.

Conclusion

Streptokinase and Urokinase are valuable thrombolytic agents used in the management of various clot-related conditions. While Streptokinase activates plasminogen to induce clot dissolution, Urokinase directly converts plasminogen to plasmin. Streptokinase is derived from streptococcal bacteria, while Urokinase is a human enzyme. Streptokinase is primarily administered intravenously, while Urokinase can be given through various routes. Both drugs have similar indications but differ in their potential side effects and contraindications. Understanding these attributes is crucial for healthcare professionals to make informed decisions regarding the appropriate use of Streptokinase and Urokinase in clinical practice.