Mindanao State University – Iligan Institute of Technology Student: ________________________________ Block: _________
COLLEGE OF NURSING
PHARMACOLOGICAL MANAGEMENT
DRUG STUDY
Brand Name: Kinlytic Generic Name: Urokinase Drug Classification: Anticoagulants, Antiplatelets & Fibrinolytics (Thrombolytics)
Dosage, Route & Frequency Side Effects
Drug-Drug & Drug-Food Adverse Reactions (By
Drug Action Indications Contraindications
Interactions System)
Recommended Prescribed (By System)
(Adults) Indirectly promotes Drug-Drug: ● For the lysis of Arteriovenous ● HEME: Bleeding ● CNS: Chills, CVA, fever,
conversion of acute massive malformation, bleeding headache
plasminogen to plasmin, ● antifibrinolytics pulmonary disorder, hypersensitivity ● CV: Hematoma, artery
an enzyme that breaks (aminocaproic acid, emboli, defined to urokinase or its dissection, embolism, ● CV: Arrhythmias,
Initial dose: 4400 down fibrin clots, aprotinin): Mutual as obstruction of components, internal cholesterol embolism including tachycardia;
international units/kg fibrinogen, and other antagonism blood flow to a bleeding, intracranial chest pain; cholesterol
IV at a rate of 90 plasma proteins, lobe or multiple aneurysm, intracranial or ● GI: Gastrointestinal embolization;
mL/hr over 10 including procoagulant ● antihypertensives: segments. intraspinal surgery during hemorrhage, retroperitoneal hypertension;
minutes factors V and VIII. Increased risk of severe previous 2 months, intra hemorrhage hypotension
hypotension cranial tumor, recent
● CNS: Stroke, intracranial ● EENT: Orolingual
cardiopulmonary
● cefamandole, ● For the lysis of hemorrhage edema
Maintenance dose: resuscitation, recent
Pharmacokinetics: cefoperazone, pulmonary
4400 international trauma, severe ● GU: Urogenital hemorrhage
cefotetan, plicamycin, emboli ● GI: Nausea, vomiting
units/kg/hr IV at a rate uncontrolled
Absorption: Urokinase is valproic acid: Increased accompanied by
of 15 mL for 12 hours hypertension (systolic ● MS: Muscle hemorrhage ● HEME: Unusual
delivered intravenously, risk of unstable blood pressure 200 mm bleeding
so the bioavailability is hypoprothrombinemia hemodynamics, Hg or higher, or diastolic ● OTHER: Fever, chills
high. and severe hemorrhage i.e., failure to blood pressure 110 mm ● MS: Back pain, myalgia
maintain blood Hg or higher), stroke ● IMMUNOLOGIC: Allergic
● corticosteroids, pressure without during previous 2 reaction ● RESP: Bronchospasm,
ethacrynic acid, supportive
Metabolism: Hepatic; salicylates months. dyspnea, hypoxemia,
measures. ● HEPATIC: Intrahepatic wheezing
rapidly cleared from the (nonacetylated): hemorrhage
circulation after IV Increased risk of GI
administration. ● SKIN: Cyanosis,
ulceration and bleeding
ecchymosis, flushing,
● enoxaparin, heparin, pruritus, rash, urticaria
NSAIDs, oral
Excretion: 20 min ● Other: Anaphylaxis,
anticoagulants, platelet-
(elimination half-life). infusion site reactions,
aggregation inhibitors:
Increased risk of metabolic acidosis
hemorrhage
Half-life:
● thiotepa: Increased
12.6±6.2 minutes. therapeutic effects of
thiotepa
Responsibilities in the Nursing Process (ADPIE) Responsibilities in the Nursing Process (ADPIE)
Assessment: Patient/Family Teaching
● Monitor vital signs and neurologic status closely. ● Instruct the patient to remain on bed rest during urokinase therapy.
● Assess for unusual bleeding or bruising. ● Inform the patient that minor bleeding may occur at wounds or puncture sites.
● Monitor INR, prothrombin time, and partial thromboplastin time.
● Monitor blood pressure for hypotension. If it occurs, notify the prescriber Evaluation/Desired Outcomes:
and
Aspects of care that should be evaluated to determine effectiveness of drug therapy:
expect to reduce the infusion rate.
● Monitor patient response to therapy (e.g. dissolution of blood clot and return of blood
● Check for bleeding at puncture sites and in urine and stool. Check for flow)
intracranial
● Monitor for adverse effects (e.g. bleeding, anemias, hypotension, etc.).
bleeding by performing frequent neurologic assessments.
● Evaluate patient understanding on drug therapy by asking patient to name the drug, its
indication, and adverse effects to watch for.
Potential Nursing Diagnoses: ● Monitor patient compliance to drug therapy.
● Ineffective tissue perfusion related to blood loss
● Decreased cardiac output related to cardiac arrhythmias and potential for
bleeding
● Risk for injury related to clot-dissolving effects
Implementation
● Use a programmable infusion pump. Change the infusion rate immediately
after completion of the loading dose.
● To prevent foaming, don’t shake urokinase when reconstituting. Consult
the pharmacist about giving drug through 0.45-micron or smaller cellulose
membrane filter.
● After arterial puncture, apply pressure for at least 30 minutes and then
apply pressure dressing. Check often for bleeding during therapy.
● To prevent bleeding and associated complications, avoid venipunctures;
use an external blood pressure cuff to measure blood pressure. If serious
bleeding begins and can’t be controlled with local pressure, stop infusion
immediately and notify the prescriber.
References:
Anticoagulants, Antiplatelets, Thrombolytics Drugs Nursing Considerations & Management. (2019, February 04). Retrieved November 26, 2020, from https://www.rnpedia.com/nursing-notes/pharmacology-drug-study-notes/
anticoagulants-antiplatelets-thrombolytics-drugs/
Kinlytic (Urokinase Injection): Uses, Dosage, Side Effects, Interactions, Warning. (2020, April 03). Retrieved November 26, 2020, from https://www.rxlist.com/kinlytic-drug.htm
Learning, J. &. (2020). Nurse's Drug Handbook 2021. S.L.: Jones & Bartlett Learning.
Multum, C. (2020, February 24). Urokinase Uses, Side Effects & Warnings. Retrieved November 26, 2020, from https://www.drugs.com/mtm/urokinase.html
Team, C. (n.d.). Urokinase. Retrieved November 26, 2020, from https://www.mims.com/philippines/drug/info/urokinase?mtype=generic
Urokinase. (2005, June 13). Retrieved November 26, 2020, from https://go.drugbank.com/drugs/DB00013
