Thrombolytic vs Fibrinolytic vs Anticoagulant agents

There is sometimes confusion among medical students that what’s the difference between the thrombolytic agents, fibrinolytic agents and the anticoagulants. In this article we’ll study the difference between them and also learn which drugs or agents perform each of these actions.

Lets check out what are these blood thinners and what’s the difference between each blood thinner.

Thrombolytic agents

What are thrombolytic agents?

Thrombolytic agents break down the thrombus or clot itself.

This means, that when a thrombolytic agent encounters a clot, it starts its breakdown by directly acting on the clot. This results in breakdown of thrombus.

Thrombolytics example

Example includes Heparin (natural thrombolytic).

When heparin is administered into the blood vessel, for example, it clears and breaks down any clot that comes along its way. Hence working as a thrombolytic agent.

Note: theoretically heparin is only anticoagulant, however it works as an indirect thrombolytic agent too.

thrombolytic vs fibrinolytic vs anticoagulant agents

Fibrinolytic agents

What are fibrinolytic agents?

Fibrinolytic agents are the one which breakdown the fibrin inside the clot but not the thrombus itself.

This means that fibrinolytic drugs given for fibrinolytic therapy and fibrinolytic agents act on the fibrin only. The other contents of thrombus remain acting.

Fibrinolytics example

Example includes Plasminogen (natural fibrinolytic).

Firbrinolytic drugs examples:

Remember not to use any drug on your own without consulting a doctor, these are highly potential drugs and can lead to death even if misused.

Fibrinolytic drugs have mainly three major classes:

  • tPA – tissue plasminogen activator
  • SK – streptokinase
  • UK – urokinase

The drugs included in these three classes have the ability to resolve a blood clot. However their detailed mechanisms of actions vary and thus their choice varies based on the exact condition and patients requirements.

Anticoagulant agents

What are anticoagulant agents?

Anticoagulants work is before the clot is formed. I.e, they prevent the clot from getting formed in first place.

Once the thrombus is formed anticoagulants can’t break it down. Instead, thrombolytic agents are used instead for the breakdown of the clot.

Thrombolytic vs Fibrinolytic vs Anticoagulant agents

Each of them have their own role in normal homeostasis as well as a therapeutic role in specific conditions. It’s important to understand the role of each of them so that the correct one can be used when needed without any confusion.

Hope it clarifies the concept of each of these. If you have any query related to thrombolytics, fibrinolytics or anticoagulants please let me know.

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13 Responses to "Thrombolytic vs Fibrinolytic vs Anticoagulant agents"

  1. isnt heparin a natural anticoagulant. thats what books say.

    • which book? please quote

      • you can have a quick search in Uptodate. Heparin is one of anticoagulant which works in coagulating system to inhibit the factor IIa (thrombin) by binding to antithrombin.

        • Heparin is an anticoagulant indeed, but it has thrombolytic affect too.

      • Heparin is an anticoagulant it prevents clot formation it does not lyse the clot

        Heparin acts as an anticoagulant by activating
        antithrombin (previously known as antithrombin III) and accelerating
        the rate at which antithrombin inhibits clotting enzymes,
        particularly thrombin and factor Xa.

        From Harrison 18th edition

  2. Hi, I’m a medical student. I would like to know if there is any difference between thrombolysis and fibrinolytic therapy in STEMI patient

    • I don’t think there should be any practical difference. As the choice of treatment is based on different factors, including: time since cardiac event and the exact symptoms.

      So what exactly is the query, elaborate that so that i can guide you in that exact context.

    • I have read that for patient presenting as STEMI, if PCI is not possible, thrombolysis can be considered within 12 hr. But some other sources stated fibrinolyic should be used. I have also checked that heparin is considered as thrombolytic, while tPA, streptokinase and urokinase are considered as fibrinolytic. Then i am confused when should I give which medication? and whether thromboytic are equal to fibrinolytic in this context? if yes, which drug should I actually prescribe?

    • ok in practical sense, both mean the same thing, people usually use only 1 term to cover both types, fibrinolytics and thrombolytics.

      Which drug to prescribe depends on various other factors.

    • then should I give heparin to all patient presenting with STEMI, while considering tPA only when it is <12hr (PCI not available or contraindicated)?

    • You will have to follow the protocol that’s being followed in your cardiac department. In the setup where i work, streptokinese is preferred

      so check that with your professor, and do update me too, you can comment on this same page when you get the update.

    • thanks for your help!!=]

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