Stroke Flashcards
goals of treatment ICH
contain and limit bleeding
remove blood
manage complications (ICP, decrease cerebral perfusion)
control causative factor
contraindicated drugs ICH
thrombolytics, anticoagulants, warfarin, antiplatelet drugs
goals of treatment SAH
quickly identify cause and prevent rebleeding
prevent brain damage
this is a dihydropyridine CCB that reduces incidence and severity of ischemic defects that can occur after a SAH
nimodipine
this drug is metabolized by CYP450 3A4 enzymes
nimodipine
causes of ischemic stroke
thrombosis
embolism
systemic hypoperfusion
rule this out prior to initiation of therapy for ischemic stroke
hemorrhagic stroke
only FDA approved therapy for treatment of acute ischemic stroke
rtPA, alteplase
onset of symptoms to administration of this drug must be less than 3 hours
rtPA
contraindications include prior ICH, sustained BP >185/110, low platelets, low HCT, recent major surgery, GI bleed, MI, stroke, head trauma, coma
rtPA
BP should be stabilized at <180/105 and maintained before treating with
rtPA
this drug is found to increase morbidity and mortality secondary to ICH
streptokinase
goals of therapy ischemic stroke
reduce progression
reduce risk of recurrent thromboembolism
prevent DVT/PE
only antiplatelet agent evaluated for the treatment of acute ischemic stroke
aspirin
DVT/PE prophylaxis acute ischemic stroke
low dose SQ heparin or LMWH