Thrombolytics and Antifibrinolytics

Thrombolytics and antifibrinolyticsantifibrinolytics have a broad range of indications in the neurocritical care setting. Optimal management of neurocritically ill patients depends on a critical understanding of the medical literature to ensure administration of appropriate pharmacologic therapies and to maximize therapeutic benefits. The efficacy of thrombolytics requires timely administration and close monitoring to minimize the risk of hemorrhage. Antifibrinolytics have established a place in the management of trauma and subarachnoid hemorrhage patients; however, their use is not without the risk of thrombosis. Physicians should be familiar with the risks and benefits of using these agents. Given the pharmacologic complexity of these medications, critical care and emergency department pharmacists can serve as key members of the interdisciplinary team to guide appropriate management.