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Fibrinolytics are indicated in acut MI ,PE ,DVT ,and acute Ischemic stroke
and shouldnt be used if there is an active bleeding or chronic MI
Thrombolytics used in STEMI if coronary angiography is contraindicated and in Pulmonary embolism
indications :
- STEMI ( ST elevation myocardial infarction )
- massive pumlonary embolism
some contraindications :
if a patient is post surgery up to 3 months
recent head truma or stroke
if the patient has bleeding from anywhere from his body
Patient should be with acute ST elevation MI and must present with in therapeutic window period ideally with in 4 hours or maximum 12 hours , in CVA presents with in 4 hours excluding hemorrhage by CT scanning , before giving ruleout absolute and relative contraindications
according to recent guidlines it is used in st elevation myocardial infarction and unstable patients with pulmonary embolism
Recent intracranial hemorrhage.recent major operation
Recent fibrinolytic infusion.
Recent hematemesis.
It depends on why you are using the fibrinolytic. Fibrinolytics can be used in cases of STEMI if PCI is not available. Fibrolytics can also be used for PE if there is hemodynamic instability. In each scenario the contraindications are the same: active bleeding, coumadin use, recent history of GI bleed, recent h/o cerbral hemorrhage, brain mass, and severe and uncontrollable HTN.
