A stroke is a disruption in brain function caused by a lack of blood flow to the brain. There are several types of medication that can be used to treat stroke patients, including blood pressure drugs, antiplatelet drugs, anticoagulants, and fibrinolytics. The type of medication prescribed depends on the type of stroke and the patient's medical history. For example, people with an irregular heartbeat (atrial fibrillation) may be prescribed anticoagulants to prevent blood clots from travelling to the brain. High blood pressure is a common cause of stroke, so medication to lower blood pressure is often used as a preventative measure. In the case of an ischemic stroke, where a clot forms in an artery supplying blood to the brain, a fibrinolytic drug such as tPA (tissue plasminogen activator) can be used as an emergency treatment to break up the clot. This must be administered within 3 to 4.5 hours of the onset of symptoms. Other medications may be used to treat post-stroke conditions such as depression, anxiety, and central pain.
Characteristics | Values |
---|---|
Type | Ischemic strokes, Hemorrhagic strokes, Transient ischemic attacks (TIAs) |
Cause | Clot in an artery that supplies blood to the brain, Bleeding inside the brain as a result of a ruptured blood vessel |
Treatment | Tissue plasminogen activator (tPA), Blood thinners, Drugs to treat underlying heart problems, ACE inhibitors, Beta-blockers, Calcium channel blockers, Angiotensin II receptor blockers, Anticoagulants, Antiplatelets, Heart rate drugs, Heart rhythm drugs |
What You'll Learn
- Antiplatelet drugs, such as aspirin, clopidogrel, and dipyridamole, prevent platelets from sticking together and forming blood clots
- Anticoagulants, such as warfarin and heparin, are blood thinners that prevent new clots and stop existing ones from growing
- Blood pressure-lowering medications, including ACE inhibitors, beta-blockers, and calcium channel blockers, are used to treat hypertension, a common cause of strokes
- Statins, such as atorvastatin and rosuvastatin, are used to lower high cholesterol levels, which can lead to plaque build-up and clogged arteries
- Atrial fibrillation drugs, such as beta-blockers and digoxin, are used to control heart rate and rhythm, reducing the risk of blood pooling and clot formation
Antiplatelet drugs, such as aspirin, clopidogrel, and dipyridamole, prevent platelets from sticking together and forming blood clots
Antiplatelet drugs are medications that prevent blood clots from forming by stopping platelets from sticking together. They are used to treat and prevent heart attacks and strokes. The most commonly used antiplatelet drug is aspirin, but this is associated with a high risk of bleeding. Therefore, aspirin therapy is not always the best option for people with no prior history of cardiovascular disease, such as strokes or heart attacks. Instead, aspirin is recommended for those at high risk of a stroke or heart attack and low risk of bleeding.
Clopidogrel is another antiplatelet drug that is prescribed to prevent blood clots. It works by making it more difficult for platelets to stick together, which is the first step in the formation of blood clots. It is usually prescribed to people who have had ischemic strokes or heart attacks to prevent secondary cardiovascular events. The usual dose for clopidogrel is 75mg once a day. It can be taken with or without food. The main side effect of clopidogrel is bleeding more easily, which may manifest as nosebleeds, heavier periods, bleeding gums, or bruising.
Dipyridamole is an adenosine reuptake inhibitor that blocks enzymes involved in clotting. It is used to help prevent blood clots.
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Anticoagulants, such as warfarin and heparin, are blood thinners that prevent new clots and stop existing ones from growing
Anticoagulants are blood thinners that prevent new blood clots from forming and stop existing clots from growing. They are usually prescribed for people with an irregular heartbeat (atrial fibrillation), which can cause blood clots to travel from the heart to the brain. They are also commonly used in people who have had a stroke to help prevent another one from occurring.
Warfarin and heparin are common anticoagulants. Warfarin is taken in pill form and can be taken for a long period of time, but it takes several days to take effect. Heparin is administered via a needle in a hospital and can only be taken for a few days.
Anticoagulants are considered more aggressive than antiplatelets. Doctors may recommend anticoagulants for people who are at high risk of a stroke or those with atrial fibrillation, an irregular heartbeat that increases the chance of developing blood clots.
If you are taking an anticoagulant, it is important to follow your doctor's instructions carefully. You may have to periodically get your blood tested to see how long it takes for it to clot. It is also important to avoid injuries as anticoagulants may cause you to bleed more if you cut or bruise yourself. Be sure to tell all healthcare providers, including your dentist, that you are taking an anticoagulant.
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Blood pressure-lowering medications, including ACE inhibitors, beta-blockers, and calcium channel blockers, are used to treat hypertension, a common cause of strokes
Hypertension, a leading cause of morbidity and mortality, accounts for 25-49% of all strokes. Angiotensin-converting enzyme (ACE) inhibitors, beta-blockers, and calcium channel blockers are used to treat hypertension and lower blood pressure, which can help prevent strokes.
ACE inhibitors work by interfering with the renin-angiotensin-aldosterone system, which regulates blood pressure. While there have been no placebo-controlled trials with ACE inhibitors in patients with hypertension, a meta-analysis of four placebo-controlled trials in patients with coronary heart disease and/or diabetes mellitus found a significant reduction in the overall risk of primary stroke. Results from the Heart Outcomes Prevention Evaluation trial suggest that the benefit of ACE inhibitors may be related to their effects on the renin-angiotensin-aldosterone system rather than blood pressure reduction. In active-control comparisons in patients with hypertension, ACE inhibitors have demonstrated reductions in primary stroke risk similar to those achieved with diuretics, beta-blockers, and calcium channel blockers.
Beta-blockers work by reducing blood flow from the heart. Randomized placebo-controlled trials with beta-blockers administered to patients with hypertension have demonstrated a 38% reduction in primary stroke.
Calcium channel blockers work by dilating blood vessels. A meta-analysis of randomized controlled trials found that calcium channel blockers significantly decreased the incidence of stroke compared to placebo, beta-blockers combined with diuretics, and beta-blockers alone. However, no statistically significant difference was found between calcium channel blockers and ACE inhibitors or diuretics.
While these blood pressure-lowering medications can help prevent strokes, they may not be suitable for everyone. For example, aspirin, an antiplatelet drug that prevents blood clots, is associated with a high risk of bleeding and is therefore not always recommended for people without a prior history of atherosclerotic cardiovascular disease. It is important to consult with a doctor to determine the most appropriate treatment option for stroke prevention.
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Statins, such as atorvastatin and rosuvastatin, are used to lower high cholesterol levels, which can lead to plaque build-up and clogged arteries
Statins are prescription drugs used to lower high cholesterol levels. They are often used when high cholesterol cannot be controlled through diet and exercise alone. Statins work by blocking the production of cholesterol in the liver, which reduces the amount of cholesterol in the blood. This, in turn, helps to prevent the build-up of plaque in the arteries, reducing the risk of heart attack and stroke.
There are several types of statins available, including atorvastatin and rosuvastatin. These two statins are the most commonly prescribed and have been extensively studied for their effectiveness and safety. They are typically taken as tablets or capsules once a day, with or without food, at the same time each day.
Statins are generally well-tolerated, with most people able to take them without experiencing significant side effects. However, some people may experience muscle pain, joint pain, liver damage, or kidney damage. It is important to discuss the potential benefits and risks of taking statins with a healthcare provider, as they are usually a lifelong commitment.
For stroke patients, statins can be an important part of their treatment plan. High cholesterol is a risk factor for stroke, as it can lead to plaque build-up and clogged arteries, increasing the likelihood of blood clots and reduced blood flow to the brain. By lowering cholesterol levels, statins can help reduce the risk of stroke and improve overall cardiovascular health.
In addition to statins, other medications may be prescribed to stroke patients to manage their condition and prevent future strokes. These include blood thinners, such as antiplatelet drugs and anticoagulants, and blood pressure-lowering medications. Lifestyle changes, such as a healthy diet, weight loss, and increased physical activity, are also typically recommended to help lower cholesterol and blood pressure, reducing the risk of stroke and improving overall health.
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Atrial fibrillation drugs, such as beta-blockers and digoxin, are used to control heart rate and rhythm, reducing the risk of blood pooling and clot formation
Atrial fibrillation is a common cardiac condition that can lead to stroke. Atrial fibrillation drugs are used to control heart rate and rhythm, reducing the risk of blood pooling and clot formation. These drugs include beta-blockers and digoxin.
Beta-blockers are a type of blood pressure medicine that alters the electrical signals in the heart to slow the heart rate. They do not necessarily fix the abnormal heart rhythm, but they can help the patient feel better. Examples of beta-blockers include bisoprolol, metoprolol, propranolol, and timolol. Side effects of beta-blockers can include weakness, dizziness, and dry mouth, eyes, and skin. Beta-blockers are not suitable for people with asthma, as they can cause severe asthma attacks. They should also be used with caution by people with diabetes, as they can block signs of low blood sugar such as a rapid heartbeat.
Digoxin is a medication that strengthens the heart muscle's contractions and works on the heart's electrical system to slow the rate that signals move from the atria to the ventricles. It is usually taken once daily, at the same time every day. While taking digoxin, patients may be advised to check their pulse daily and report a slower-than-recommended heart rate to their doctor. Digoxin may cause drowsiness, and patients are advised not to drive or operate machinery until they know how the medication affects them. Side effects of digoxin can include a slow or fast heartbeat and changes in vision, such as flashes of light, sensitivity to light, and colour changes.
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Frequently asked questions
There are several types of medication used to treat stroke patients, including:
- tPA (tissue plasminogen activator)
- Blood thinners (antiplatelet drugs and anticoagulants)
- Blood pressure-lowering medications
- Cholesterol-lowering medications
- Atrial fibrillation drugs
- Antidepressants
- Drugs for central pain
- Osteoporosis supplements
- Muscle spasm drugs
The exact mix of medication will depend on the type of stroke the patient experienced, their medical history, and their risk factors for a stroke.
There are two types of blood thinners used to treat stroke patients: antiplatelet drugs and anticoagulants. Antiplatelet drugs prevent platelets from sticking together and forming blood clots. Anticoagulants prevent new blood clots from forming and keep existing blood clots from getting larger.
Some examples of antiplatelet drugs used to treat stroke patients include ASA (acetylsalicylic acid, Aspirin), clopidogrel, dipyridamole, and ticlopidine.
Some examples of anticoagulants used to treat stroke patients include warfarin, heparin, apixaban (Eliquis), dabigatran (Pradaxa), edoxaban (Savaysa), and rivaroxaban (Xarelto).