Strokes Flashcards
who are strokes more common in?
men, african amercians
most common causes of stroke
HTN
trauma
illicit drugs use (amphetmaines, coccaine)
vascular malformations
what drugs are contraindicated with hemorrhagic stroke?
thrombolytics
anticoagulants (Heparin, LMWH)
Warfarin
antiplatelet drugs (ASA, clopidogrel, Gp IIb/IIA inhibitors)
hemmorrhagic stroke tx
osmotic diuretics drainage of CSF fluid via catheter neuromuscular blockades hyperventilation prophylactic antiepileptic therapy
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)
Subarachnoid hemorrhage
Tx for subarachnoid hemorrhage
surgical clipping
prevention of cerebral vasospasm
what is a dihydropyridine CCB that should be started w/i 96 horus of SAH onset and continued x 21 days
Nimodipine
Inadequate supply of oxygen and nutrients to an area of the brain due to thrombosis, embolism, systemic hypoperfusion.
Ischemic stroke
what is the only FDA approved therapy for treatment of acute ischemic stroke?
Recombinant tissue plasminogen activator (rtPA, alteplase)
how long should you wait to start DVT prophylaxis w/ rtPA therapy.
24 hours
what are contraindications of thromblytics with ischemic stroke?
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
when must thrombolytics be given within for ischemic stroke?
3 hours of symptoms onset.
what can you use for blood pressure control with stroke? (to get tPA on board)
labetalol
nitropaste
what is the only antiplatelet agent for tx of acute ischemic stroke?
325 mg within 48 hours
may be combined w/ SQ heparin for DVT prophylaxis
when should you lower the BP with ischemic stroke?
SBP >220 or MAP >120
