Stroke Meds

Question 0

Aminocaproic acid

Tranexamic acid

Answer 0

-fibrinolysis inhibitor
MOA
-binds to plasminogen preventing it from activating into plasmin–>preventing fibrinolysis

Question 1

Alteplase

Answer 1

-fibrinolytic drug
-most effective w/in 3 hrs of stroke, effective up to 4.5 hrs
MOA
-is an r-tPA, which mimics t-PA–> tissue plasminogen activator–>activates plasminogen to plasmin, which starts fibrinolysis
ADE
-bleeding
-intracranial hemorrhage
Contraindications
-hemorrhage, uncontrolled hypertension, active internal bleeding, aneurysm, seizure

Question 2

Aspirin

Answer 2

-platelet aggregation inhibitor
-used for prevention of strokes
MOA
-blocks COX-1
-inhibits production of arachidonic acid–>inhibits production of TA2 (Thromboxane A2)–>platelet aggregator
ADE
-bleeding
-gastric irritation (unless enteric coated)
Contraindications
-if allergic to other NSAID (cross-sensitivity)

Question 3

Clopidogrel

Answer 3

-platelet aggregation inhibitor
MOA
-blocks ADP receptor (P2Y12)–>increase in cAMP–>overall inhibit platelet aggregation
Contraindications
-if pt has poor metabolizer (test if pt has CYP2C19 gene) plavix

Question 4

Dipyridamole

Answer 4

-platelet aggregation inhibitor
MOA
-blocks uptake of adenosine into platelets
-increases local concentration of adenosine–>acts on platelet A2 receptor–>stimulates cAMP levels–>overall inhibits platelet aggregation

Question 5

Warfarin

Dabigatran

Answer 5

• anticoagulants

- last resort

Question 6

Cyroprecipitate

Answer 6

• coagulant
• insoluble precipitate prepared by slow thawing of fresh frozen plasma
• contains factor VIII, vWF, *fibrinogen, and factor XIII