Stroke Flashcards
Define ischemic stroke
caused by a thrombus that forms during a cerebral atherosclerotic infarction sometimes referred to as a non-cardioembolic stroke, to indicated the origin of disease as being in the brain, not the heart
Define cardioembolic stroke
an ischemic stroke that occurs when an embolus forms in the heart and travels to the brain
list hemorrhagic strokes
intracerebral hemorhage
subarachnioid hemorrhage
subdural hematoma
what is the less serious stroke
transient ischemic attack or TIA
alteplase MOA
binds to fibrin in a thrombus and converts plasminogen to plasmin, resultining in fibrinolysis
what is the only fibrinolytic agent that is used in acute ischemic stroke
alteplase
What criteria needs met to give alteplase
give within 3 hours of onset
within 60 mins of getting to hospital
BP <185/110
alteplase dose for stroke
0.9 mg/kg max dose 90 mg
Absolute contraindications for alteplase
active bleed
recent head injury (3 months)
stroke past 3 months
BP >185/110
What BP meds are preferred prior to alteplase use
labetalol
nicardipione
clvidipine
Which BP meds are preferred for secondary stroke prophylaxis
ACEi
thiazide diuretics
BP goal for secondary stroke ppx
<130/80
When is an antiplatelet recommended
for pt with non-cardioembolic ischemic stroke or TIA
Indication for mannitol in stroke
used in intracerebral hemorrhage to lower the ICP
Mannitol MOA
produces an osmotic diuresis by increasing the osmotic pressure of the glomerular filtrate in the kidneys this inhibits tubular reabsorption of water and electrolytes and increases urinary output. mannitol reduces ICP by withdrawing water from the brain parenchyma and excreting it in the urine
