week 8 - stroke Pharm Flashcards
Atorvastatin MOA
Liver can’t make cholesterol because HmG-CoA reductase is inhibited
need more LDL receptors in the liver
need more HDL to bring in more cholesterol
Fun facts about Atorvastatin
Take in the evening - when cholesterol is typically made
Watch for Rabdo/myopathy
* leg muscle pain specifically
Hepato toxicity (Rabdo)
Assess GI
What is Atorvastatin used for
reduce atherosclelorosis that leads to ischemic stroke
What class is atorvastatin
Lipid lowering med
Labetalol class
Beta adrenergic blocker/ antihypertensive
what is Labetalol used for
Emergency!
Lower BP - post acute stroke
What does Labetalol affect
Beta 1 - heart and kidneys
Beta 2 - circulatory and lungs
Alpha 1 - blood vessel dilation
fun facts about Labetalol
drops BP quickly
high alert med - monitor 5-15 min vitals
Fluid overload
High risk for falls
Don’t get up for 3 hours
careful of BS due to hypoglycemic unawareness
What is ASA given for
TIA
ischemic stroke
it’s prevention
it’s treatment (within 48hrs of stroke)
what do we care about with ASA
cannot give with bleeding disorders
cannot give with low platelets
caution with renal/liver poor function and alcohol
give with food
when CAN we give tPA
ischemic Stroke onset <4.5 hrs
Why do we give tPA
reestablish blood flow to the brain by breaking up clot in blocked artery
What are we worried about with tPA
intercranial bleeding
active bleeds
aortic dissection
Heparin monitoring
aPTT
Antidote- protamine sulfate
thrombocytopenia - mini clots
HIT - platelets drop 50%
if we see blue/black fingers & toes, stop heparin
BP rules for tPA
If candidate for tPA after ischemic stroke- BP MUST BE <185/110
If NOT a candidate for tPA after ischemic stroke- BP MUST be <220/120. Do this with antihypertensives
