MEDICCA PRESS A MEDICAL CONTENT COMPANY1 UROKINASE DOSE WHEEL PROPOSAL FOR BSVL DETAILS OF DELIVERABLES Type of input:Dosage wheel or dosage card Title of the input:Urokinase in clinical Practice A Ready Reckoner Periodicity:One-time input Input details: Dose wheel - B5 size; printed on both sides; with a pivot for rotating the dose flaps to get the correct dosage for the indication; 4-color jobDosage card B5 size; printed on both sides; 4-color job Target customers:Doctors Molecule:Urokinase Indications:Acute myocardial infarction, deep vein thrombosis, pulmonary embolism, pleural effusion Contents:The dosage wheel/dosage card will incorporate the dose of urokinase in different conditions and the details of administration route of administration, if dilution is needed, rate of administration, any need for concomitant therapy etc.

MEDICCA PRESS A MEDICAL CONTENT COMPANY2 UROKINASE DOSE WHEEL PROPOSAL FOR BSVL Sample contents for the dose wheel / dosage card IndicationDosage of urokinaseAdministrationConcomitant therapy Myocardial infarction Systemic administration 1 to 2 million IUDoses up to 3 million IU have been used to treat acute myocardial infarction (AMI) Direct intracoronary artery infusion: Average total dose of 500,000 IUAlternate dose -at a rate of 6000 IU /min for up to 2 hours, at a rate of 20,000 to 25,000 IU/min for 10 to 20 minutes, up to a total dose of 250,000 to 500,000 IU Administered IV once over 15 to 30 minutes Infused into the occluded artery at a rate of 6000 IU /min for up to 2 hours Prior to beginning urokinase, a bolus of heparin 2500 to 10,000 units IV once should be givenPrior heparin administration should be considered when calculating the heparin dose Heparin therapy (without a loading dose) is recommended when the thrombin time has decreased to less than twice the normal control value Urokinase should be given following heparin bolus Pulmonary Embolism Initial: 4400 IU/kg ideal body weight (IBW) Maintenance: 4400 IU/kg (IBW) /hour Administered as an IV bolus over 10 minutes Administered as a continuous IV infusion for 12 hours Heparin therapy (without a loading dose) is recommended when the thrombin time has decreased to less than twice the normal control value. Deep Vein Thrombosis Initial: 4400 IU/kg ideal body weight (IBW) Maintenance: 4400 IU/kg (IBW) /hourAdministered as an IV bolus over 10 minutes Administered as a continuous IV infusion for 72 hours Heparin therapy (without a loading dose) is recommended when the thrombin time has decreased to less than twice the normal control value Pleural effusion 100,000 IUIntrapleural administration, once a day for 3 days Their use may be most beneficial in high risk patients of an older age or with co-morbidity where surgery has a greater risk.