Stroke Flashcards
Transient Ischemic Attack (TIA)
Cerebral ischemic event lasting less than 24 hrs (typically only minutes) without apparent neurologic deficit
Completed stroke
Cerebral ischemic acute event with deficit that persisits
Choice of secondary preventive stroke treatment is dependent on:
Patient individualization
Criteria for Dual Antiplatelet Therapy
- Stent + new cerebral ischemia
- cerebral ischemia w/in 90 days
- Patent Foramen Ovale
- AFib + not able to take Coumadin
Which antiplatelet agents block ADP receptors?
-Ticlopidine
- Clopidogrel
- Prasugrel
Which antiplatelet agents inhibit cyclooxygenase and thromboxane?
Aspirin
Which antiplatelet agent increases plasma adenosine + inhibits platelet phosphodiesterase
Dipyridamole
Aspirin stuff
Enteric coated to avoid GI discomfort (not bleeds)
Chewable = better absorption
younger + higher weight = higher dose needed
aspirin allergy possible
Aggrenox stuff
ASA + ER dipyridamole
ADE: Headache, abdominal cramping, diarrhea
Do not use Dipyridamole if:
Spastic colon/ IBS
Migraine Hx
Do not use ASA 81 if:
patient needs rapid antiplatelet effects
(you can make it work if you give 325 mg then taper down)
Do not use Clopidogrel if:
Patient needs CCB or PPI
Which NSAID does not decrease effectiveness of ASA?
Celecoxib (Celebrex)
Clopidogrel DDI Solutions
PPI -> H2RA (or pantoprazole)
Use any statin other than Rosuvastatin (Crestor)
CCB -> BB, ACE, ARB
Ambien/Lunesta -> Sonata
Glyburide -> glipizide / metformin
What to try if patient is resistant to both ASA and clopidogrel?
Ticagrelor
Prasugrel
