STROKE

Question 1

Initial ischaemic stroke management

Answer 1

Alteplase – administer within 4.5 hours, and haemorrhage stroke has been excluded

Aspirin 300mg OD 14 days from onset

Question 2

Long term management for stroke (5)

Answer 2

1st line Clopidogrel 75mg OD OR
2nd line Aspirin 75mg OD

• May require PPI
• Start high-intensity statins as soon as they can swallow
• If not already on anti-HTN - manage HTN

Question 3

What anti-hypertensive may be less beneficial post stroke

Answer 3

Beta-blockers

Question 4

Haemorrhagic stroke management

Answer 4

1. Surgery for removal of a haematoma
2. Rapid BP lowering - do not give if structural cause, GCS <6,

Question 5

what is Transient Ischaemic attack?

Answer 5

Temporary loss of blood supply to parts of the brain – Last few minutes and fully resolves in 24 hours.

Question 6

Initial treatment TIA

Answer 6

Aspirin 300mg
* If already on 75mg – carry on, no need for 300mg dose

Question 7

Long-term TIA treatment

Answer 7

Same as stroke (AP, PPI, HTN, STATIN etc) BUT INTIAL DAPT

Dual therapy with aspirin +clopidogrel - UP TO 90 day)

Dual therapy with aspirin plus ticagrelor - UP TO 30 days