SCRN Pharmacological Management

Question 1

A patient with acute ischemic stroke presents within 3 hours of symptom onset. Which medication is the first-line thrombolytic therapy?

Accepted Answer

Alteplase (tPA)

Answer

Reteplase

Answer

Streptokinase

Answer

Tenecteplase

Question 2

What is the maximum dose of IV alteplase for acute ischemic stroke treatment?

Accepted Answer

0.9 mg/kg, max 90 mg

Answer

1.2 mg/kg, max 120 mg

Answer

0.6 mg/kg, max 60 mg

Answer

0.9 mg/kg, max 100 mg

Question 3

A patient receiving IV alteplase for acute ischemic stroke develops sudden severe headache and hypertension. What is the priority action?

Accepted Answer

Stop the infusion and obtain emergent CT head

Answer

Slow the infusion rate and monitor closely

Answer

Administer antihypertensive medication and continue infusion

Answer

Administer fresh frozen plasma immediately

Question 4

Which antiplatelet agent is recommended for secondary stroke prevention in patients with non-cardioembolic ischemic stroke?

Accepted Answer

Clopidogrel or aspirin

Answer

Aspirin

Answer

Warfarin

Answer

Heparin

Question 5

A patient with ischemic stroke secondary to atrial fibrillation is started on anticoagulation. Which drug class is preferred for long-term secondary prevention?

Accepted Answer

Direct oral anticoagulants (DOACs)

Answer

Unfractionated heparin

Answer

Low molecular weight heparin

Answer

Aspirin plus clopidogrel

Question 6

What is the target blood pressure goal during IV alteplase infusion for acute ischemic stroke?

Accepted Answer

< 180/105 mmHg

Answer

< 140/90 mmHg

Answer

< 160/100 mmHg

Answer

< 200/110 mmHg

Question 7

Which medication is used to rapidly lower blood pressure in a hypertensive emergency associated with acute ischemic stroke when tPA is indicated?

Accepted Answer

Labetalol or nicardipine

Answer

Nitroprusside

Answer

Hydralazine alone

Answer

Oral amlodipine