Drugs And Stroke Flashcards
True or false, an ischaemic stroke occurs when a diseased or weakened blood vessel ruptures and blood leaks into the surrounding tissues
False
True or false streptokinase is an anticoagulant
False
True or false, abciximab is a therapeutic antibody and anti-fibrinolytic agent
False
The immediate prognosis for a haemorrhagic stroke is worse than for an ischaemic stroke, true or false
True
Recombinant rTPA is licensed for the treatment of stroke, true or false
True
Aspirin inhibits the enzyme cyclo-oxygenase
True
Altepase is an example of an antiplatlet agent
False
Which of the following are correct for intracerebral haemorrhage?
- Are common in patients with chronic hypertension
- Involve a small amount of bleeding damage, usually reversible
- Are hard to diagnose at the bedside
- Account for 10% of all strokes
1, 3 & 4
The clotting cascade is triggered by:
- Exposed collagen fibres
- Damage to blood vessels
- 1 & 2
3
Heparin in an inhibitor of anti thrombin, true or false
False
Clopidogrel and ticlopidine cause inhibition of ATP receptors of GPIIb/IIIa
False
Antiplatlet drugs are only effective after haemorrhagic stroke, true or false
False
A thrombus that has travelled to the brain from a more proximal location (heart or from wall of a proximal artery) is called an
Embolism
An occlusion, usually in the atheromatous carotid, vertebral or cerebral artery is a
Thrombus
A build up of fatty deposits on the inside walls of arteries is
Atherosclerosis
An irregular heartbeat that can cause clots to form in the heart is
Atrial fibrilation
What is the body’s own ‘clot buster’ and degrades fibrin
Plasmin
What is plasmin formed from
Plasminogen
Plasminogen is activated by _________ _________ which diffuse into the thrombus, converting plasminogen to ________
Plasminogen activators
Plasmin
Which drugs activate plasminogen recombinant tissue plasminogen activators (rTPA’s)
Fibrinolytic drugs
Altepase is an example of what kind of drug
Fibrinolytic
Which drug ezymically activates plasminogen to give plasmin which digests fibrin and fibrinogen, lysing the clot?
Late paste
How is altepase administered
IV
Which drug produces these side effects:
Nausea and vomiting
Bleeding
Hypotension
Altepase
How long do you have to administer altepase after symptom onset?
4.5 hours
Is aspirin an NSAID?
Yes
Which drug inhibits COX1, preventing thromboxane formation
Aspirin
Which drugs prevent GPIIB/IIA receptor expression?
Antiplatlet
What does GPIIB/IIA receptor expression do?
Stimulates the activation of new platelets and increases aggregation
What stimulates the activation of new platelets and increases aggregation?
GPIIB/GPIIA
What activates GPIIB/IIA receptor expression in platelet aggregation
Thromboxane
Which drug inhibits thromboxane synthesis, preventing thromboxane formation
Dipyridamole
Which drug blocks the actions of ADP at purinergic (ADP) receptors, inhibiting the binding of fibrinogen
Clopidogrel
Which drug is a GPIIB/IIIA receptor antagonist, inhibiting platelet aggregation
Abciximab
Abciximab, clopidogrel, dipyridamole and aspirin are all what types of drugs
Anti platelet drugs
What type of drug activates antithrombin?
Anticoagulant
Which drug activates the body’s own anti-clotting factors - antithrombin III
Heparin
What type of drug is dalteparin sodium?
Heparin - anticoagulant
Enoxaparin, dalteparin and tinzaparin are all which type of drug
Heparin, anticoagulant
Which drug inhibits vitamin k reductase
Warfarin
Where does warfarin act on?
Liver, inhibiting the enzyme vitamin K reductase
What has symptoms similar to a stroke but is short lived and patients recover completely
Transient ischaemic attack
What percentage of strokes are ischaemic
85%
What is used to determine whether a stroke is ischaemic or haemorrhagic
CT or MRI scan
Is altepase a short or long acting drug
Short acting
Modifying platelet aggregation is important in ______ thrombosis
Arterial
Modifying coagulation is most successful in ________ thrombosis
Venous
How many mg of aspirin should be given to someone having an ischaemic stroke?
300mg
How many weeks after an ischaemic stroke/TIA is aspirin typically given
2 weeks
Which drug activates antithrombin III
Heparin
Which form of heparin requires less monitoring?
Low molecular weight heparins
Which works faster heparin or warfarin
Heparin
What factors affect warfarins clotting time
Diet, drinking, acute illness
When is the use of anticoagulants indicated for acute phase of ischaemic stroke
AF
What drugs are given if a patient is having a haemorrhagic stroke?
None
