Flashcards in 4 Stroke Deck (26):
Medical risk factors 6
HRT? (Unsure but not recommended)
Non modifiable risk factors 5
Risk assessment tool for stroke is called.....
Risk assessment score for PE/DVT is called
3 primary prevention of stroke treatments
Lipid lowering drugs
Control of hypertension
Anticoagulation with other risk factors such as AF
Primary prevention treatments non-pharmacological
Diet, exercise, weight management
Reduce alcohol intake
Pateints with AF are .... times more likely to have a stroke
Chadsvasc do you score someone for hypertension if it is controlled?
Modifiable risk factors 5
Which to initiate first, OAC or anti hypertensives in AF
What is first line treatment for AF
Rate limiting CCB
What is second line for AF
Beta blocker plus digioxin
NOT BETA BLOCKER WITH CCB - heart block
(You could use CCB and digoxin in think...)
Third line for AF
Elective DC conversion
• Flecainide or Sotolol
Amioderone shown to be benifical with warfarin but....
There is a interaction so INR is likely to be unstable while loading
What score is used to assess risk of stroke post Tia?
Post Tia would would also check
Heart rate (for AF)
You might ct scan if you suspect another problem
What to do if someone with AF presents with a stroke
You still need to rule out the bleed so withhold antiplatelets and anticoagulants
Therapies to prevent recurrent Stoke 6
Anticoagulants (with AF)
What long term anti platelet is given for stroke
Post stroke what to change from aspirin to something else
After 14 day change to anticoagulants if with AF
(If without AF they should just have clopidogrel,
NO FUCKING ANTICOAGULANTS)
When after a stroke can you start messing with other patient meds
Bonus stuff to assess in stroke?
SALT for swallow
Stroke in diabetic patient? 2
Remember to rule out hypo
Consider VRIII if they can't eat
Why don't we treat BP in the first two weeks after stroke?
We don't want to reduce cerebral perfusion as this could result in brain damage.
If they are normally on anti hypertensives you could continue unless hypo.
What do you do about the risk of DVT during admission for a stroke?
There are special guidelines so you might use these.