Stroke

Question 1

• Antiplatelet drug
• NSAIDs= inhibits COX-1
• Works acutely so given in first 24 hours
• Given for 2 weeks
• Anti-platelet regime used in addition with dipyridamole or clopidogrel
• Minimal side effects

Answer 1

Aspirin

Question 2

• Antiplatelet drug
• Inhibits thromboxane synthase
• Prevents thrombin formation
• Often used in conjunction with aspirin
• Dizziness, upset stomach, muscle or joint pain, headache, mild skin rash/ itching

Answer 2

Dipyridamole

Question 3

• Antiplatelet drug
• Prevention of GPIIIa/ IIIb receptor expression
• Antagonise actions of ADP at ADP receptors
• Severe bleeding or pain, vomiting blood, weakness or numbness, allergic reactions

Answer 3

Clopidogrel

Question 4

• Antiplatelet drug
• Preventing GPIIIa/ IIIb receptor interaction
• Prevents linking of platelets to fibres

Answer 4

Abciximab

Question 5

• Anticoagulant
• Activates anti-thrombin III
• Prevents conversion of fibrinogen-> fibrin
• Given IV immediately after the event
• Numbness, weakness, severe headache, confusion, chest pain, cough, wheezing, fast RR, fats HR

Answer 5

Heparin

Question 6

• Anticoagulant
• Acts on liver, inhibits enzyme vit. K reductase
• Inhibiting number of clotting factors
• Takes days to reverse
• Interacts with many other drugs
• Requires patient to changed diet
• Dose must be individual and monitored closley

Answer 6

Warfarin

Question 7

• Used in prevention of blood clots, DVT and MI
• Its a naturally occurring polysaccharide
• Bleeding, alergic reactions, rejection at injection site

Answer 7

Low molecular heparin

Question 8

An example of a low molecular heparin drug is…

Answer 8

Dalteprin

Question 9

• Thrombin inhibitor
• Inhibits circulating and clot bound thrombin
• Quick onset and short 1/2 life
• Alternative to heparin
• Pain in back or pelvis, N+V, abdominal pain , restlessness, headache, fever, anxeity

Answer 9

Bivalirudin

Question 10

• Thrombin inhibitor
• Derived from yeast cells
• Pain in back or pelvis, N+V, abdominal pain , restlessness, headache, fever, anxeity

Answer 10

Lepirudin

Question 11

• A drug able to dissolve a clot or re-open an artery or vein
• Allergy/ Anaphylaxis

Answer 11

Thrombolytic agents

Question 12

• Tissue plasmin activation
• Protein involved in breakdown of clots
• Key enzyme of fibrinolytic pathway

Answer 12

Alteplase rTPA

Question 13

• UPA- urokinase- type Plasmin Activator

- Bleeding, hives, difficulty breathing, swelling of face

Answer 13

Urokinase

Question 14

• Used to breakdown clots

- Nausea, bleeding, low BP

Answer 14

Streptokinase