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Medicine

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Neurology

Question
22 out of 27
 

The only thrombolytic agent approved for the treatment of

acute ischemic stroke is: (AIIMS May 2011, Nov 2010)



A Tissue Plasminogen activator
B Streptokinase

C Urokinase
D Pro-urokinase

Ans. A

Tissue Plasminogen activator

Medical support

1). BP should be maintained using fluids, vasopressors.

a. If BP >185/110 β1 – blocker esmolol

b. Deep vein thrombosis Heparin

c. Cerebral edema – Peaks on 2nd or 3rd day I.V. Mannitol

2). – Agent used is Recombinant Tissue Plasminoge Activator (rt PA) Indications

Indications

a. Clinical diagnosis of stroke

b. CT shows no hemorrhage or significant edema

c. Symptoms duration ≤ 3hours.

d. Age ≥ 18years

Pentoxifylline, helps blood flow, has been used to treat venous leg ulcers. It is indicated for the treatment of leg pain caused chronic occlusive arterial disease of the limbs.

3. Anticoagulation – Agent used is heparin

Antiplatelet agents –

a. Aspirin

b. Ticlopidine

c. Clopidogrel

d. Absixicimab (Glycoprotein IIb/IIIa inhibitors)

Note.The only thrombolytic agent approved for the treatment of acute ischemic stroke is: Tissue Plasminogen activator (Ref. Hari-18th ed., pg-3272, table 370.1)

4). Neuroprotective agents –

Prolongation of tolerance of brain to ischemic long enough to allow other measures to be employed to mitigate ischemia. Agents used are:

a. Hypothermia

b. Drugs blocking excitatory amino acid pathways.

Neurology Flashcard List

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