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28 Cards in this Set
- Front
- Back
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What are the 2 types of strokes?
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• Ischemic • Hemorrhagic
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What are the 3 general categories of risk factors for strokes?
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• non-modifibale • partially modifiable • modifiable
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Give examples of non-modifiable risk factors for stroke
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• age (risk doubles after 55) • race (hispanics & blacks at greater risk than whites) • gender (male > female)
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What are partially modifiable risk factors for stroke?
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• cholesterol • DM
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What are modifiable risk factors for stroke?
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• HTN • Smoking • Atrial Fibrillation • Obesity • HRT (hormone replacement therapy)
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What are ways to reduce risk factors for stroke?
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• control HTN • smoking cessation • tighter control of diet in diabetic patients • cholesterol reduction
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What are warning signs for a stroke?
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• loss of balance • severe headache with no cause • sudden numbness to any part of extremities (usually face, arm, or leg) • sudden confusion • sudden trouble speaking • trouble speaking
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What is the recommended anticoagulation therapy for a patient with a low risk for stroke?
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Aspirin 325 mg daily
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What are the low risk factors for stroke?
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None
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What is the recommended anticoagulation therapy for a patient with a moderate risk for stroke?
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• Aspirin 325 mg daily (if only one risk factor) • Warfarin (+/- ASA 81 mg if more than one risk factor)
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What are moderate risk factors for stroke?
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• 65-75 yrs old • diabetes • CAD
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What is the recommended anticoagulation therapy for a patient at high risk for stroke?
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• Warfarin • Aspirin 325 mg daily (if Warfarin is contraindicated or refused)
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What are high risk factors for stroke?
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• > 75 years old • CHF • HTN • Prosthetic heart valve • prior stroke • TIA • Thromboembolism
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What is the treatment for an acute ischemic stroke?
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• Heparin • Thrombolytics
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What is the only thrombolytic approved to use for stroke?
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Tissue Plasminogen Activator (TPA)
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What is the recommended time frame for using TPA to treat stroke?
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• recommended use within 3 hours of symptoms • after 3 hours, there is no benefit with increased risk of bleeding
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How long after administration of TPA will you see improvement?
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3 months
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What is the dose for administering TPA?
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• 0.9 mg/kg IV (10% as a bolus, remainder over 1 hour) • maximum dose of 90 mg
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What are contraindications for administering TPA?
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• Active bleeding • High BP at time of stroke • ICH or history of ICH • Neoplasms (Brain) • Platelets < 100,000 • Recent surgery • Seizure • Subarachnoid bleeds
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What are secondary prevention methods to reduce risk for stroke?
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• reduction of risk factors • have carotid checked • antiplatelet therapy
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What are different antiplatelet therapies that can be used for prevention of stroke?
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• Aspirin • Aggrenox (Aspirin/Dipyridamole) • Ticlodipine • Clopidrogel • Warfarin
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What is the dose of aspirin?
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between 81 - 1300 mg per day
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What is the dose for Aggrenox (aspirin/dipyridamole)?
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One capsule BID
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What are adverse effects of Aggrenox (aspirin/dipyridamole?
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• Dyspepsia • Headaches • Nausea
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Where does Ticlodipine work?
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inhibits ADP induced platelet aggregation
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Why is Ticlodipine seldom used?
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Ticlodipine has a very high incidence of thrombocytopenia and neutropenia
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Wha is the dose of Plavix?
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75 mg PO daily
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What are indications for using Warfarin as antiplatelet therapy?
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• second ischemic event • AFib
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