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Advanced MS Chapter 62 Medications

Advanced MS Chapter 62 Medications

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Michele McNabb

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4 Slides • 6 Questions

1



Advanced MedSurg
​Chapter 62
Medications

2









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

3

Fresh frozen plasma
Vitamin K

​warfarin

Anticoagulation Antidotes


​Dabigatran
andexanet alfa
rivaroxaban
apixaban



idarucizumab

4

​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

5

Multiple Choice

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

1

warfarin

2

vitamin K

3

antihypertensives

4

nicardipine

6

Multiple Choice

The most common cause of intracerebral hemorrhage.

1

AVM

2

hypertension

3

aneurysm

4

coughing

7

Multiple Choice

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

1

30 minutes

2

2 hours

3

3 hours

4

45 minutes

8

Multiple Choice

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

1

10 -15 days

2

30 - 75 days

3

20 - 50 days

4

21 - 90 days

9

Multiple Choice

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

1

Losartan

2

Atorvastatin

3

Clopidogrel

4

t-PA

10

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.

1

3 hours

2

10 hours

3

3 hours

4

24 hours



Advanced MedSurg
​Chapter 62
Medications

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