STROKE

Question 1

TIA

Answer 1

transient ischemic attack

mini-stroke symptoms disappear on their own within minutes or a few hours

seek attention, often warning for a future full stroke

Question 2

ACT F.A.S.T

Answer 2

face
arms
speech
time

Question 3

bleeding risk with alteplase

Answer 3

tPA
check for:
- Active bleed, internal or external
- conditions or lab that increase bleed (severe hypertension, INR >1.7)
- DI w/ bleeding risk (e.g. anticoagulant use)

Question 4

Alteplase

Answer 4

Activase
Cathflo activase - single use vial 2mg
.9mg/kg max 90, give 10% boluse over 1min then infuse remainder over 60min

rule of intracranial hemorrhage before use
contra pt used LMWH <24 hr or direct trombin inhibitor or factor Xa inhibitor <48 hrs, INR >1.7, severe uncontrolled BP> 185/110, history of recent strong <3months

Question 5

Nimodipine

Answer 5

Nymalize
do not admin IV or parenteral route (death and serious life-threatening adverse event)
if capsule cannot be swallowed, contents may be withdrawn with parenteral syringe, then transferred to an oral syringe

DHP CCB more selective for cerevreal arteries due to increased lipophilicity

Question 6

hypertension in HF

Answer 6

thiazide diuretics (first), ACE/ARB

Question 7

Niaspan couseling

Answer 7

at night with low-fat snack

Question 8

loop diuretics cause

Answer 8

ototoxicity

Question 9

time since symptom onset stroke for tPA use

Answer 9

4.5 hours less good.
also contra in BG<50
INR >1.7
BP>185/110