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Flashcards in Stroke II Deck (35)
1

What are the drugs that reduce the recurrence of ischemic stroke?

Antiplatelets

2

What are the antiplatelet drugs used?

-ASA
-Ticlopidine
-Clopidogrel

3

What is the RRR of ASA, ticlopidine, and clopidogrel for recurrence of stroke?

-ASA (13%)
-Ticlopidine (21%)
-Clopidogrel (8%)

4

What is the MOA of clopidogrel?

P2Y12 inhibitor, (an ADP receptor antagonist) which is important in the activation of platelets and cross linking of fibrin.

5

What is the MOA of ticlopidine?

ADP inhibitor

6

What is the MOA of dipyridamole?

Phosphodiesterase inhibitor--enzyme normally breaks down cAMP to increase platelet aggregation response

7

What is the drug that inhibits Gp IIb/IIIa?

Abciximab

8

What is the RRR of coumadin of having a stroke with a-fib? ASA?

70% RRR w/ Warfarin
20% RRR w/ ASA

9

What is the MOA of dabigatran?

Direct thrombin inhibitor

10

What are the Xa inhibitors?

-Rivaroxaban
-Apixaban

11

What is the prophylaxis for cardioembolic strokes? Others?

Warfarin

All else, antiplatelets

12

What is the most important controllable risk factor for strokes?

HTN

13

When is carotid endarterectomy indicated / better than medication control for SYMPTOMATIC patients?

More than 50% stenosis

14

When is carotid endarterectomy indicated / better than medication control for ASYMPTOMATIC patients?

60%

15

At what percent of carotid stenosis is surgery absolutely indicated for stroke prophylaxis?

70%

16

The recurrence of stroke is highest later or earlier post stroke?

Earlier

17

What percent of people have PFO?

30%

18

What is the role of occluding PFOs to prevent stroke?

Still experimental

19

What is the core of the stroke?

Area of necrosis

20

What is the penumbra?

Ischemic, but not infarcted tissue

21

What is the benign oligemia?

Area around the area of ischemia

22

What is the primary determinant of the damage with stroke?

Blood flow

23

What is the emergent treatment for a stroke? (5)

-ABCs
-Oxygen
-IV access with NS
-HOB 15 degrees
-NPO

24

What is the CT that should be ordered with a suspected stroke?

Non-contrast CT

25

What are the labs that should be drawn with a suspected stroke?

-PT/PTT
-CBC
-ECG
-CXR

26

What is the most important question for a stroke patient?

When were you last normal

27

Avoid HTN treatment with stroke unless over what?

220/120 unless giving tPA. Then 185/110.

28

What is the timeframe for tPA?

4.5 hours of onset

29

What is the chance of full recovery with tPA? Risk of death 2/2 ICH?

30-50% full recovery

60% chance of death

30

When is an IV thrombolysis indicated?

within 6 hours, and after tPA is given

31

What are the labs that are drawn in the post-stroke eval? (3)

-Hypercoagulable profiles
-Lipid panels
-BG

32

What are the components of post-stroke care?

-Avoid aspiration
-Avoid DVT
-Mobilize
-Antiplatelet/antiplatelet and a statin

33

True or false: unless contraindicated, statins are started on all post stroke patients?

True

34

What is the number one risk factor for stroke? Which risk factor is the one we can control most?

Age
HTN

35

What must be done following tPA administration?

ICU admission for 24 hours