Drugs and Stroke Flashcards
1
Q
What is a cerebral infarction?
A
- Blockage, thromboembolic infarction (~85% cause of stroke)
2
Q
What is a cerebral haemorrhage?
A
- Damage/bleed; intracranial haemorrhage (~15% cause of stroke)
3
Q
What are examples of antiplatelet drugs?
A
- Aspirin
- Abciximab
- Clopidogrel
- Dipyridamole
4
Q
What are examples of anticoagulants?
A
- Antithrombin
- Heparin
- Warfarin.
5
Q
What are examples of thrombin inhibitors?
A
- Bivalirudin
- Lepirudin
6
Q
What are examples of low-molecular-weight heparins?
A
- Dalteparin
7
Q
What are examples of anticoagulant therapies?
A
- Protamine sulphate
- Vitamin K
8
Q
What are examples of thrombolytic agents?
A
- Altepase (rTPA)
- Streptokinase
- Urokinase
9
Q
What are examples of systemic haemostatic agents?
A
- Aprotinin
10
Q
How do thrombolytic agents work?
A
- Increase the conversion of plasminogen into plasmin (degrades fibrin)
- altepase - r-tPA - recombinant tissue plasminogen activators, recombinant HUMAN proteins so non-antigenic
- only effective if given within 3 hours
- must confirm ischaemic event before giving tPA by brain imaging
- never give for haemorrhage as they cause bleeding!
11
Q
How do antiplatelet drugs work?
A
- Reduce the adhesion, activation and aggregation of platelets
- Aspirin - blocks COX-1 enzyme, prevents thromboxane.
- Dipyridamole - reduces thromboxane formation
- Clopidogrel antagonise actions of ADP
- Abciximab - prevents linking of platelets to fibres.
12
Q
How do anti-coagulant drugs work?
A
- Heparin - activates bodies own anti-clotting molecules (antithrombin III)
- Warfarin - acts on the liver to inhibit the enzyme vitamin K reductase
- SIDE EFFECTS - interact with lots of drugs and need extensive monitoring.
13
Q
How do thrombin inhibitors work?
A
- These are an alternative to warfarin but have less side effects.
14
Q
Which treatment is a clot-busting drug that must be administered within a few hours of onset of a stroke?
A
- Altepase
15
Q
Aspirin is effective as a treatment for patients who have suffered an ischaemic sroke as it:
A
- Decreases risk of stroke reoccurence.
