Fake internet pharmacies cash in on the trusted reputation of their high-street counterparts. Of the estimated 40, active online pharmacies worldwide, some are legal, above board and managed by well-known corporate brands, but most are bogus and run by criminal gangs, with not a pharmacist among them. The Irish Medicines Board urges caution. Counterfeit drugs may contain too much, too little or none of the active ingredient. Some have been found to contain toxic substances such as rat poison or arsenic. An year-old Irish girl last year underwent an emergency colectomy, having consumed diet pills purchased over the internet.
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Factors that determine those individuals who will show symptoms of drug interaction are unknown.
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Only specific professional groups can work within a PGD, including radiographers, paramedics, nurses, podiatrists, physiotherapists, speech therapists and pharmacists. If a non-permitted professional group uses a PGD then they will break the law.
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They are most effective given soon after the thrombus has formed, for example within of a myocardial infarction. All of the drugs in use activate plasminogen resulting in the production of the active enzyme plasmin. Clinical uses include treatment of acute myocardial infarction, pulmonary embolism and peripheral thromboembolism and in the restoration of circulation through arterial grafts and intravenous catheters.
Examples are streptokinase and alteplase. Streptokinase is naturally produced by streptococcal bacteria whereas alteplase is recombinant tissue plasminogen activator. Streptokinase is antigenic and may provoke an allergic reaction, so it should not be used too often.