Managing Medications Post-Stroke Flashcards

1
Q

What are the 2 types of strokes?

A

Ischaemic
Haemorrhagic

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2
Q

What happens once someone has had a stroke?

A

They are then at further risk of another vascular event

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3
Q

How are strokes different?

A

Lasts more than 24hrs

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4
Q

How are transient ischaemic attacks (TIA) different?

A

Less than 24hrs

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5
Q

What are complications in early period?

A

Cerebral oedema = fluid on brain
Delirium
Seizures
VTE = pulmonary embolism
Cardiac complications
Infection

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6
Q

What are the long term complications?

A

Continence problems
Fatigue
Oral health
Cognitive dysfunction
Mood + wellbeing
Communication
Swallowing

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7
Q

What does the treatment of continence depend on?

A

Underlying cause of it

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8
Q

What may be the underlying cause of continence?

A

Times toileting
Prompted voiding
Bladder retaining
Pelvic floor exercises
Drug treatments

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9
Q

What is fatigue?

A

Tiredness or lack of energy
BUT following a stroke its not relieved by rest

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10
Q

How do you manage fatigue?

A

Assess person for mental + physical factors
Treat any reversible causes
Provide person + their family with info + support

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11
Q

How do you manage oral health?

A

Carry out mouth care at least 3 times a day
Especially for those who are tube fed

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12
Q

What is the dental gel called that you can give them?

A

Chlorhexidine

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13
Q

How do you manage cognitive dysfunction?

A

Consider screening all people with stroke or TIA for cognitive impairment
Then if necessary refer people to dysfunction assessment

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14
Q

How do you manage mood + wellbeing?

A

Discuss with stroke physician
Consider referring for behavioural therapy
Consider brief psychological interventions (eg. motivational interviewing)
Then antidepressants

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15
Q

Describe the use of antidepressants

A

Monitor for adverse effects
Treat for at least 4 months
If mood not improved after 2-4 weeks
Check adherence before considering dose increase or alternative

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16
Q

How to manage communications?

A

Offer support from speech + language therapy

17
Q

How to manage swallowing?

A

Monitor dietary intake + nutritional stats
Refer to dietician if needed
Refer to stroke specialist if person unable to swallow

18
Q

How many stroke patients does dysphagia affect?

A

More than 50%

19
Q

Can dysphagia improve?

A

YES - within 2 weeks for most people

20
Q

What are the complications for dysphagia?

A

Aspiration pneumonia
Choking
Compromised nutrition + dehydration
Reduced QoL

21
Q

What are the options for overcoming swallowing issues?

A

Crushing + dispersing medications
Switching formulations

22
Q

When it is a dispersible tablet does it have to be dispersed in H2O?

A

No it can be in juice

23
Q

What must you do if it is switched to a liquid?

A

State the new dosage

24
Q

If you crush it into H2O, what must you do?

A

State the amount of water to disperse it into

25
Q

What must you do if you are crushing multiple medicines?

A

Each one should be prepared + provided separately