Eab Clinical guidelines Acute Stroke Edlow JA, Smith EE, Stead LG, et al. Clinical policy 00 use of intravenous tpa for the management of acute ischemic stroke in the emergency department. Ann Emerg med2013;61:225-43 Jauch ec saver jL. Adams hP et al. gueselines for o000oc0= the early management of patients with acute ischemic stroke. Stroke 2013: 44: 870-947 Del Zoppo GJ, Saver JL, Jauch EC, Adams HP. Expansion of the time window for treatment of acute ischemic stroke with intravenous tissue plasminogen activator. Stroke 2009; 40: 2945-8 KENTUCKY College of Pharmacy
Clinical Guidelines • Acute Stroke – Edlow JA, Smith EE, Stead LG, et al. Clinical policy: use of intravenous tPA for the management of acute ischemic stroke in the emergency department. Ann Emerg Med 2013;61:225-43. – Jauch EC, Saver JL, Adams HP, et al. Gueselines for the early management of patients with acute ischemic stroke. Stroke 2013;44:870-947. – Del Zoppo GJ, Saver JL, Jauch EC, Adams HP. Expansion of the time window for treatment of acute ischemic stroke with intravenous tissue plasminogen activator. Stroke 2009;40:2945-8
Eab Clinical guidelines Atrial fibrillation 00 Furie Kl, goldstein lb. albers gw, et al. oral antithrombotic agents for the prevention of stroke in nonvalvular atrial fibrillation Stroke o000oc0= 2012:43. KENTUCKY College of Pharmacy
Clinical Guidelines • Atrial fibrillation – Furie KL, Goldstein LB, Albers GW, et al. Oral antithrombotic agents for the prevention of stroke in nonvalvular atrial fibrillation. Stroke 2012;43
Eab Clinical guidelines ° Primary prevention 00 Goldstein LB. Bushnell cd. adams r, et al Guidelines for the primary prevention of stroke Stroke201142:517-84 o:. Secondary prevention Furie kl Kasner se, adams rj, et al. guidelines or the prevention of stroke in patients with stroke or transient ischemic attack, Stroke 2011:42:227-76 KENTUCKY College of Pharmacy
Clinical Guidelines • Primary prevention – Goldstein LB, Bushnell CD, Adams RJ, et al. Guidelines for the primary prevention of stroke. Stroke 2011;42:517-84. • Secondary prevention – Furie KL, Kasner SE, Adams RJ, et al. Guidelines for the prevention of stroke in patients with stroke or transient ischemic attack. Stroke 2011;42:227-76
Eab Case GP, a 48-year old attorney, was told he was hypertensive, but did not take his blood pressure medications. he was apparently well o.., until 6 months ago, when he developed several episodes of 00 blurred vision, like a shade coming down, involving his left eye These attacks each lasted less than an hour. he was referred for neurologic evaluation but because of a busy schedule, canceled the appointment. a)-. Several weeks later, he complained to his wife of a left-sided headache. She found him 1/2 hour later, slumped in a chair apparently confused and paralyzed on the right side. She brought him to the ed within 20 minutes of finding him. Neurologic examination in the hospital revealed total paralysis of the right arm and severe weakness of the right face. the leg was only mildly affected. The patient was globally aphasic; he was unable to produce any intelligible speech and appeared to understand only very simple phrases. KENTUCKY College of Pharmacy
Case • GP, a 48-year old attorney, was told he was hypertensive, but did not take his blood pressure medications. He was apparently well until 6 months ago, when he developed several episodes of blurred vision, "like a shade coming down," involving his left eye. These attacks each lasted less than an hour. He was referred for neurologic evaluation but because of a busy schedule, canceled the appointment. • Several weeks later, he complained to his wife of a left-sided headache. She found him 1/2 hour later, slumped in a chair apparently confused and paralyzed on the right side. She brought him to the ED within 20 minutes of finding him. Neurologic examination in the hospital revealed total paralysis of the right arm and severe weakness of the right face. The leg was only mildly affected. The patient was globally aphasic; he was unable to produce any intelligible speech and appeared to understand only very simple phrases
Eab Case A CT scan revealed an infarct in the territor oE: of the middle cerebral artery of the left side No intracranial blood was seen on ct 当· It is now1 hour after admission @.. What are GP's risk factors? 3。 Is he a tPA candidate KENTUCKY College of Pharmacy
Case • A CT scan revealed an infarct in the territory of the middle cerebral artery of the left side. No intracranial blood was seen on CT. • It is now 1 hour after admission. • What are GP’s risk factors? • Is he a tPA candidate?