Stroke medicine

   Stroke medicine

Stroke medicine involves the management of all forms of stroke and transient ischaemic attack (TIA) and   whole patient pathway( which include diagnosis, investigation, acute treatment, rehabilitation and re-integration, secondary prevention and long-term complications).  stroke isl the most common cause of severe and  acquired disability in adult life, therefore  new and emerging interventions can reduce the personal and societal impact of the condition. stroke is a  medical emergency,it can cause permanent damage to the nervous system  and If it is not promptly diagnosed  and treated, it may lead to death

In the majority of patients blockage of an artery in the brain due to  clot (thrombosis) is the most common cause of a stroke. The part of the brain that is supplied by the clotted blood vessel is then deprived of blood and oxygen. As a result of the deprived blood and oxygen, the cells of that part of the brain die and the part of the body that it controls stops working. Typically, a cholesterol plaque in a small blood vessel within the brain that has gradually caused blood vessel narrowing ruptures and starts the process of forming a small blood clot.the stroke or TIA will be a manifestation of atherosclerotic disease, and coexisting conditions such as ischaemic heart disease, peripheral vascular disease, diabetes and hyperlipidaemia are common. However,  in younger patients, there may be  unusual causes of stroke such as arterial dissection, migraine, thrombophilic and vasculitic disorders.

Drug therapy is a relatively recent approach to the treatment of stroke, that will minimize the effects of the stroke Much of the damage caused by a thrombotic or embolic stroke occurs in the first six hours. The development of new clot-dissolving drugs and medications  make the brain more resistant to stroke commonly called as neuroprotective agents. medications for the stroke include

Antiplatelet medicines

  •   Aspirin is most often used to prevent TIAs and strokes.
  • Aspirin combined with dipyridamole is a safe and effective alternative to aspirin.
  •  clopidogrel may be used for people who cannot take aspirin.

Anticoagulants

Anticogulants prevent   the formation of blood clots and keep existing blood clots from getting bigger. If there is atrial fibrillation,then we will  probably take an anticoagulant.

Statins

statins lower cholesterol level. It can greatly reduce the risk of  stroke  in people who have had a TIA. Statins even protect against stroke in people who do not have heart disease  or high  cholesterol.

 

 blood pressure  medicines

If  high blood pressure is there  then we have  to take medicines  that  lower it. Blood pressure medicines include:

  • .Angiotensin II receptor blockers (ARBs)
  • . Angiotensin- converting enzyme(ACE) inhibitors
  • . Beta blockers
  • . Calcium channel blockers
  • . Diuretics

Drugs that dissolve clots are known as thrombolytic agents.  if  these drugs should be given within the first few hours after stroke,  they minimize stroke damage.

  • Thrombolytic Agents (tissue plasminogen activator [tPA]), widely used to dissolve clots that cause heart attacks, are also effective for dissolving artery-blocking clots in the brain during the critical early stages of stroke. Early administration of tPA after a stroke can reduce neurological damage.
  • Neuroprotective Agents – Medications that make the brain less susceptible to the damaging effects of a stroke are called neuroprotective agents.

 

Article publié pour la première fois le 21/10/2011

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