Advanced MS Chapter 62 Medications

Advanced MedSurg
​Chapter 62
Medications

Platelet inhibiting medications
Aspirin
Extended release dipyridamole plus aspirin
clopidogrel


*Used in TIA or strokes from suspected embolic or thrombotic causes
typically taken for a period of 21 to 90 days post stroke/TIA

​Statins
atorvastatin
simvastatin

*recommended even if LDH <100

Direct oral anticoagulants (DOACs)
​warfarin - target INR 2-3
dabigatran
apixaban
edoxaban
rivaroxaban
If anticoagulants are contraindicated
Aspirin alone is the best option, although the addition of clopidogrel to aspirin is also used

*Used in TIA or strokes from suspected
cardioembolic stroke/atrial
fibrillation

​

Antihypertensives
ACE inhibitors
Diuretics
or combination
*post stroke

​Thrombolytic Agent
t-PA

*must be given within 3 hours of symptoms

​Medications in Ischemic Stroke

​If not a candidate for t-PA use IV heparin or low molecular weight heparin

​Osmotic diuretic
mannitol

​

Fever
reducer
acetaminophen

Fresh frozen plasma
Vitamin K

​warfarin

​Anticoagulation Antidotes

​Dabigatran
andexanet alfa
rivaroxaban
apixaban

​

idarucizumab

​DVT prevention
low molecular weight heparin

Fever Reducer
Acetaminophen

​Anti-epileptics
levetiracetam
phenytoin

​


insulin
for
hyperglycemia

​Analgesics
for head/neck pain

​Antihypertensives
IV: nicardipine, labetalol, hydralazine

​Prevention
of
Vasospasm:
nimodipine

​Reduce ICP:
mannitol

​


hypertonic
solution

​Medications in Hemorrhagic Stroke

Multiple Choice

Secondary prevention in a patient with atrial fibrillation may be treated with this medication.

• warfarin

• vitamin K

• antihypertensives

• nicardipine

Multiple Choice

The most common cause of intracerebral hemorrhage.

• AVM

• hypertension

• aneurysm

• coughing

Multiple Choice

What is the timeframe for treatment of stroke with t-PA?

• 30 minutes

• 2 hours

• 3 hours

• 45 minutes

Multiple Choice

How long can clopidogrel land aspirin be taken after a stroke?

• 10 -15 days

• 30 - 75 days

• 20 - 50 days

• 21 - 90 days

Multiple Choice

Most current stroke prevention guideline now includes this medication even if the LDL cholesterol is below 100mg/dL

• Losartan

• Atorvastatin

• Clopidogrel

• t-PA

Multiple Choice

A patient has received t-PA within 2 hours of ischemic stroke. CT imaging also showed patient has a small bowel obstruction and will require NG tube insertion. The nurse knows that the risk of bleeding is greatest for this timeframe and optimally should wait _____ to insert NG tube.

• 3 hours

• 10 hours

• 3 hours

• 24 hours