drugs used in cerebrovascular disorders 1-141010
DESCRIPTION
farmakologiTRANSCRIPT
DRUGS USED IN CEREBROVASCULAR DISORDERS
Dwi Indria Anggraini Medical School Lampung University
CASE
25 year old woman
•R sided numbness and aphasia
•tingling in R face, spreads hand & foot
•after 10 mins–word finding difficulty
•full recovery in 30 mins
•nicotine stained fingers
•bp190/110
•65 year old man
•Found collapsed at home by wife
•Not moving right side very well
•Not speaking
•nicotine stained fingers
•bp190/110
Stroke : Organization of Care
Management of Acute Stroke: Non-specific Treatment
Hypertension
Hypoxia
Hydration / Nutrition
Bladder management
Hyperglycaemia / Pyrexia
Venous thromboembolism
Needs in relation to movement and handling, avoidance of pressure sores
A. Inhibition of clotting cascade in vivo
SPECIFIC THERAPIES
NEUROPROTECTION
ANTICOAGULANTIA
PLATELET INHIBITORS
ANTITHROMBOTIC AGENTS
• Acute thromboembolic disease in selected patients maybe treated by the administration of agents that activate the conversion of plasminogen to plasmin-as serine protease that hydrolyze fibrin and thus dissolves cloth
ANTITHROMBOTIC AGENTS
Activation of plasminogen by fibrinolytic agents
Alteplase (tpA)
Streptokinase
ANTITHROMBOTIC AGENTS
Streptokinase uses as systemic fibrinolytic state that can lead to bleeding
problem
Alteplase acts more locally on the thrombotic fibrin to
produce fibrinolysis
ANTITHROMBOTIC AGENTS
• A comparison of streptokinaseand alteplase.
• Degradation Of an unwanted thrombus And a beneficial hemostatic p lug by plasminogen actlvators.
Mechanismof action of streptokinase