Urokinase
Urokinase (Abbokinase)
Urokinase
(your-oh- KYE-nayz)
Pregnancy Category: B Abbokinase Abbokinase Open-Cath (Rx)

Classification: Thrombolytic agent

Action/Kinetics: Urokinase converts plasminogen to plasmin; plasmin then breaks down fibrin clots and fibrinogen. Onset: rapid; duration: 12 hr. t 1/2: < 20 min, although effect on coagulation disappears after a few hours.

Uses: Acute pulmonary thromboembolism. To clear IV catheters that are blocked by fibrin or clotted blood. Coronary artery thrombosis. Investigational: Acute arterial thromboembolism, acute arterial thrombosis, to clear arteriovenous cannula.

Contraindications: Active internal bleeding, history of CVA, within 2 months of intracranial or intraspinal surgery or trauma, recent cardiopulmonary resuscitation, intracranial neoplasm, arteriovenous malformation or aneurysm, known bleeding diathesis, severe uncontrolled arterial hypertension. Any condition presenting a risk of hemorrhage, such as recent surgery or biopsies, delivery within 10 days, pregnancy, ulcerative disease. Also hepatic or renal insufficiency, tuberculosis, recent cerebral embolism, thrombosis, hemorrhage, SBE, rheumatic valvular disease, thrombocytopenia.

Special Concerns: Use in septic thrombophlebitis may be hazardous. Use with caution during lactation. Safe use in children has not been established.

Side Effects: CV: Superficial bleeding, severe internal bleeding transient hypotension or hypertension, tachycardia. Allergic: Rarely, skin rashes, bronchospasm. Other: Fever, chills, rigors, N&V;, dyspnea, cyanosis, back pain, hypoxemia, acidosis.

Drug Interactions: Anticoagulants, aspirin, heparin, and indomethacin the risk of bleeding when given with urokinase.

How Supplied: Powder for injection: 5000 IU; 9000 IU; 250,000 IU

Dosage
?IV Infusion Only Acute pulmonary embolism.
Loading dose: 4,400 IU/kg administered over 10 min at a rate of 90 mL/hr; maintenance: 4,400 IU/kg administered continuously at a rate of 15 mL/hr for 12 hr. May be followed by continuous IV heparin infusion to prevent recurrent thrombosis (start only after thrombin time has decreased to less than twice the normal control value).
Coronary artery thrombi.
Initial bolus: Heparin, as a bolus of 2,500-10,000 units IV; then, begin infusion of urokinase at a rate of 6,000 IU/min (4 mL/min) for up to 2 hr (average total dose of urokinase may be 500,000 IU). Urokinase should be administered until the artery is opened maximally (15-30 min after initial opening although it has been given for up to 2 hr).
Clear IV catheter.
Instill into the catheter 1-1.8 mL of a solution containing 5,000 IU/mL.