Pharmacotherapy stroke summary

Ischemic Stroke
,
Stroke
· Acute onset of focal neurological
↳ Transient Ischemi Attack (T)
deficit due permanent CNS +issue infraction ·
Temporary ischemic without intraction
,

with reversible symptoms .
Risk factors
>
- modifiable :
Acute Stroke Treatment
· HiN (treat < 140/90mmig) G OT > minimize Neurological injury & prevent long term
disablitity
-




·
Dyslipidemia (statin +
lifestyle) rtPA(Recombinant Activator) -
· +issue Plasminogen > IV 0
Amg/kg
.




· DM (Control BP) 4 5hrs of
(max 90mg) . Given within .


symptom onset
.


· Smoking (cessation # ClE INR > 1 7
: :



, platelets <100 , 000 , or recent
bleeding .



· AFib (Antithrombotic risk)
· Aspirin >
- Start within 24-48hrs if rtPA not given .
(325mg) .




>
-
Non modifiable :


Age low birth weight male,
, ,
· BP managment >
- Treat if BP 2201120mmHg or
<185/llOmmily
genetics , race (Black) .
before rtPA Med nicardipine Nanitropresid
. : labetalol , , or
(Retractorya

Secondary Prevention
(1) Antiplatelets : (2) Anticoagulation for cardioembolic stroke :



·
Aspirin (50-325mg/day) : Most studied (Dual therapy Not recommended
· Warfarin Dabigatran ·
Apixaban Rivaroxban
↑ risk of hemorrhage


·
Clopidogrel (75mg/day) : if allergic Aspirin (3) statin :
High intensity for atherosclerosis stroke
prevention
· Aspirin + Dipyridamole :
reftcacy ,
can
cause headach (4) BP managment : Thiazide diuretic or ACE I