Strokes Flashcards

1
Q

who are strokes more common in?

A

men, african amercians

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2
Q

most common causes of stroke

A

HTN
trauma
illicit drugs use (amphetmaines, coccaine)
vascular malformations

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3
Q

what drugs are contraindicated with hemorrhagic stroke?

A

thrombolytics
anticoagulants (Heparin, LMWH)
Warfarin
antiplatelet drugs (ASA, clopidogrel, Gp IIb/IIA inhibitors)

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4
Q

hemmorrhagic stroke tx

A
osmotic diuretics 
drainage of CSF fluid via catheter 
neuromuscular blockades 
hyperventilation 
prophylactic antiepileptic therapy
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5
Q

Bleeding into the CSF → rapidly increased intracranial pressure (ICP). Can result in coma and death and brain damage. Abrupt onset (as opposed to gradual w/ hemorrhagic stroke)

A

Subarachnoid hemorrhage

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6
Q

Tx for subarachnoid hemorrhage

A

surgical clipping

prevention of cerebral vasospasm

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7
Q

what is a dihydropyridine CCB that should be started w/i 96 horus of SAH onset and continued x 21 days

A

Nimodipine

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8
Q

Inadequate supply of oxygen and nutrients to an area of the brain due to thrombosis, embolism, systemic hypoperfusion.

A

Ischemic stroke

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9
Q

what is the only FDA approved therapy for treatment of acute ischemic stroke?

A

Recombinant tissue plasminogen activator (rtPA, alteplase)

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10
Q

how long should you wait to start DVT prophylaxis w/ rtPA therapy.

A

24 hours

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11
Q

what are contraindications of thromblytics with ischemic stroke?

A
Prior ICH
sustained BP >185/110
platelets 400
major surgery w/i 14 days 
GI bleed w/i 21 days
MI in past 3 months
stroke/ head trauma w/i prior 3 months
coma
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12
Q

when must thrombolytics be given within for ischemic stroke?

A

3 hours of symptoms onset.

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13
Q

what can you use for blood pressure control with stroke? (to get tPA on board)

A

labetalol

nitropaste

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14
Q

what is the only antiplatelet agent for tx of acute ischemic stroke?

A

325 mg within 48 hours

may be combined w/ SQ heparin for DVT prophylaxis

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15
Q

when should you lower the BP with ischemic stroke?

A

SBP >220 or MAP >120

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16
Q

what can you give for CVT/PE prophylaxis following ischemic stroke?

A

low does SQ heparin
LMWH
(wait longer for bleeding to be under control w/ hemorrhagic stroke)

17
Q

what is a combination of ER-dipyridamole + ASA that inhibits PDE mediated platelet aggregation. recommended over ASA alone

A

Aggrenox

18
Q

what can be used for patients allergic to aspirin. shouldn’t be combined w/ aspirin in stroke patients.

A

Clopidrogel

19
Q

what drug classes are recommended for recurrent stroke prevention (due to HTN)

A

thiazides

ACEI