Describe secondary prevention for strokes (after a TIA)
Antiplatelet drugs: baby aspirin and clopidogrel
tPA
Thrombolytic therapy for an ischemic stroke
Breaks up EVERY clot in body
Must be taken within 3 hours of the onset of stroke symptoms- ESSENTIAL
-after 3 hours the risks > benefits
Must be 18+ years old with a Dx of an ischemic stroke
tPA contraindications
Any recent surgery, bleeds
Severe HTN
Bleeding risks
Hemorrhagic stroke or minor ischemic stroke
Recent trauma excluding head trauma
3 meds for seizure prophylaxis after a hemorrhagic stroke
Phenytoin
Corticosteroids
Diuretics
Neurogenic bladder meds
Anticholinergics to suppress bladder contraction
alpha-blockers to decrease outflow resistance
Antispasmodic drugs like baclofen
Peptic ulcer prevention
H2 blockers
PPIs
-good for spinal cord injury and IICP- at risk for ulcers
Mannitol
Osmotic diuretic for IICP- drags fluid into vascular space and promotes excretion
Hypertonic saline for IICP
Works with Mannitol to drag fluid into vascular space and get excreted
Cabamazepine
Phenobarbital
Phenytoin
Old anti-seizure meds
very good, lots of SEs
Pentobarbital
Barbiturate used to induce a coma as a last ditch effort for patients with IICP
Continuous EEG needed
Dangerous long term
Levodopa with Carbidopa
Used to treat and diagnose Parkinson’s
Levodopa: synthetic dopamine that crosses the BBB
Carbidopa: inhibits the enzymes that break down Levodopa to ensure it can reach the BBB safely
Only works for a few years- may be used as the final treatment effort to prolong life
Sumatriptan
For moderate to severe migraines
-affects serotonin receptors
-reduces inflammation
-vasoconstricts
-best when taken at onset of symptoms
-avoid if pt has heart disease or stroke risk
Topiramate
Preventative treatment for migraines
Antiseizure med
SE: hypoglycemia, paresthesia, weight loss, cognitive changes
Take for 2-3 months for effectiveness
Gardasil vaccine
HPV vaccine- encouraged for males and females starting at age 9 to prevent HPV and cervical cancer
Tamoxifen
Selective estrogen receptor modulator- treats male breast cancer and reduces risk of breast cancer
Finasteride
Blocks conversion of testosterone into dihydrotestosterone, a hormone that causes prostate enlargment
for BPH
Drug alert: harms male fetuses- any pregnant woman should not even handle this pill (even if female fetus)
Sildenafil
A vasodilator for erectile dysfunction
-viagra
Tamsulosin
1 most used Alpha-blocker used for BPH: relaxes prostate muscle and promotes urine outflow
