Pharmacological Management Flashcards

Which medication is contraindicated within 24 hours of IV alteplase administration?

Answer: Anticoagulants and antiplatelet agents

Anticoagulants and antiplatelet agents are contraindicated for 24 hours after tPA to reduce the risk of hemorrhagic transformation.

A nurse administers 10% of the alteplase dose as an IV bolus over 1 minute. What happens with the remaining 90%?

Answer: Infused over 60 minutes

Standard alteplase administration is 10% as an IV bolus over 1 minute and the remaining 90% infused over 60 minutes.

Statins are recommended after ischemic stroke primarily because they reduce which risk factor?

Answer: LDL cholesterol and recurrent stroke risk

High-intensity statin therapy lowers LDL cholesterol and has been shown to reduce recurrent ischemic stroke and cardiovascular events.

A patient with ischemic stroke secondary to carotid artery stenosis is started on dual antiplatelet therapy. Which combination is most commonly used short-term?

Answer: Aspirin plus clopidogrel

Short-term dual antiplatelet therapy with aspirin plus clopidogrel is recommended for high-risk TIA or minor stroke to reduce early recurrent events.

Which medication is used to treat symptomatic cerebral hypoperfusion (vasospasm) after subarachnoid hemorrhage in addition to nimodipine?

Answer: Induced hypertension with vasopressors (Triple-H therapy)

Triple-H therapy (hypertension, hemodilution, hypervolemia) using vasopressors is used to augment cerebral perfusion during symptomatic vasospasm.

A patient with ischemic stroke is found to have diabetes. Which antihypertensive class has additional benefit for secondary stroke prevention in diabetic patients?

Answer: ACE inhibitors or ARBs

ACE inhibitors and ARBs provide both blood pressure reduction and renoprotective benefits, and are preferred antihypertensives for diabetic stroke patients.

Which electrolyte disturbance is commonly managed pharmacologically after subarachnoid hemorrhage due to cerebral salt wasting or SIADH?

Answer: Hyponatremia

Hyponatremia is common post-SAH due to cerebral salt wasting or SIADH and is managed with hypertonic saline or fludrocortisone depending on the mechanism.