ASC ASC Stroke Pharmacotherapy & Medication Management

Question 1

What is the standard IV alteplase (tPA) dose for acute ischemic stroke in eligible adult patients?

Accepted Answer

0.9 mg/kg (max 90 mg), 10% as bolus then remainder over 60 min

Answer

1.0 mg/kg (max 100 mg) over 30 minutes

Answer

0.6 mg/kg (max 60 mg) over 60 minutes

Answer

0.9 mg/kg (max 90 mg) infused over 30 minutes

Question 2

Which antihypertensive agent is considered first-line for blood pressure management in acute ischemic stroke patients who are tPA candidates with BP > 185/110 mmHg?

Accepted Answer

IV labetalol or IV nicardipine

Answer

Oral amlodipine

Answer

IV hydralazine alone

Answer

Sublingual nifedipine

Question 3

For how long after IV tPA administration should blood pressure be maintained below 180/105 mmHg?

Accepted Answer

24 hours

Answer

12 hours

Answer

6 hours

Answer

48 hours

Question 4

A patient receives IV tPA and develops orolingual angioedema 30 minutes into the infusion. What is the immediate pharmacologic intervention?

Accepted Answer

Stop infusion, administer diphenhydramine, ranitidine, and IV methylprednisolone

Answer

Continue infusion and give epinephrine only if airway threatened

Answer

Administer subcutaneous epinephrine and continue tPA at half dose

Answer

Stop infusion and administer protamine sulfate

Question 5

Which antiplatelet agent is recommended for secondary stroke prevention in patients with non-cardioembolic ischemic stroke who cannot tolerate aspirin?

Accepted Answer

Clopidogrel

Answer

Ticagrelor

Answer

Prasugrel

Answer

Dipyridamole alone

Question 6

What is the recommended early dual antiplatelet therapy (DAPT) regimen for minor ischemic stroke (NIHSS ≤ 3) or high-risk TIA within 24 hours of symptom onset?

Accepted Answer

Aspirin plus clopidogrel for 21 days then aspirin alone

Answer

Aspirin plus ticagrelor for 90 days

Answer

Clopidogrel plus warfarin for 30 days

Answer

Aspirin alone indefinitely