Stroke

Question 1

What is the immediate action to be taken if a patient is suspected of having transient ischaemic attacks?

Answer 1

Aspirin 300mg STAT (clopidogrel 75mg STAT if contraindicated). Long term management should then be offered.

Question 2

Outline the initial management of ischaemic stroke.

Answer 2

Alteplase recommended if it can be given within 4.5 hours of symptom onset. Treatment with aspirin 300mg/clopidogrel 75mg for 14 days should be initiated 24 hours after thrombolysis.

Question 3

What medication should be considered for AF patients who have just had an ischaemic stroke, after aspirin treatment?

Answer 3

Anticoagulants.

Question 4

What medication is used for the long-term management of a transient ischaemic attack?

Answer 4

MR dipyridamole combined with aspirin. If aspirin contraindicated - MR dipyridamole alone. If both contraindicated - clopidogrel alone.

Question 5

What medication should be used for the long-term management of ischaemic stroke?

Answer 5

Clopidogrel. If clopidogrel contraindicated, MR dipyridamole and aspirin. Statin initiated 48 hours after stroke symptoms onset. Hypertension treated, not with beta-blockers.

Question 6

What medication should be used for the long-term treatment of ischaemic stroke associated with AF?

Answer 6

Warfarin. Statin initiated 48 hours after stroke symptoms onset. Hypertension treated, not with beta-blockers.