Few major takeaway points to remember if SK has been chosen for thrombolytic therapy
- Major allergic reaction due to SK infusion particularly the first time is a rare event, although mild pyrexia and shivering may occur.
- Mere hypotension during SK infusion without any other sign of allergic reaction is not considered a reaction. It may be just a histaminoid event and can be handled with slowing of the infusion, intravenous fluids (IVF) bolus, or transient pressor support.
- The efficacy of SK as a thrombolytic therapy is not decreased if an allergic reaction occurs.
- If an allergic reaction occurs after SK infusion, patient stays at risk for an allergic reaction for about 7-8 years
1. Tsang TS, Califf RM, Stebbins AL, et al. Incidence and impact on outcome of streptokinase allergy in the GUSTO-I trial. Global Utilization of Streptokinase and t-PA in Occluded Coronary Arteries. Am J Cardiol 1997; 79:1232.
2. Squire IB, Lawley W, Fletcher S, et al. Humoral and cellular immune responses up to 7.5 years after administration of streptokinase for acute myocardial infarction. Eur Heart J 1999; 20:1245.