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During a stroke, normal blood flow to the brain is disrupted and brain cells can’t get enough oxygen. Medication is often a first step in stroke treatment, given to break up a blood clot in the case of an ischemic stroke or to stop the bleeding in the brain in the case of a hemorrhagic stroke. Many stroke medications may also be prescribed to help reduce the risk of another stroke.
Stroke Medication: Understanding t-PA
Tissue plasminogen activator, or t-PA, is one of the best weapons when it comes to stroke treatment. Given by injection, t-PA breaks up a clot that is causing an ischemic stroke and allows blood flow to the brain to resume. It can only be given to a person having an ischemic stroke — never a hemorrhagic stroke because t-PA can only worsen bleeding for those patients. Unfortunately, the use of t-PA is restricted. Current recommendations state that t-PA should only be given within three hours of the onset of the stroke, a short window of opportunity that shows the importance of early recognition of symptoms and quick stroke treatment. Ongoing research is providing information that may eventually extend that window, but it will still be only a matter of hours.
Stroke Medication: Other Drug Treatments
A number of other medications are prescribed to help stroke patients recover and to prevent another stroke:
•Aspirin. Aspirin helps to thin the blood, to treat a current stroke and reduce the risk of another one. Ischemic stroke patients are almost always given aspirin in the emergency room. However, it is very important that people who already take aspirin each day or take another blood-thinning medication tell doctors so they are aware the blood is already thinned. A person having a hemorrhagic stroke should not take aspirin because it can increase bleeding in the brain.
•Anticoagulants. Blood-thinning medications like warfarin (Coumadin) are also called anticoagulants, meaning they prevent blood clots from forming. These medications are sometimes given to help thin the blood of ischemic stroke patients. Anticoagulants can't treat a clot that has already formed, but can keep another clot from forming. People with atrial fibrillation, a major risk factor for stroke,
take an anticoagulant to help prevent blood clots. As with aspirin, be sure to tell doctors if you already take one of these medications. Blood thinners may cause you to bleed too much if you get a cut or bruise easily if you are injured, so be extra careful when taking them.
•Antiplatelet medications. These drugs also help prevent blood clots from forming by preventing platelets (cells found in the blood that allow the blood to clot) from sticking together and forming an ischemic stroke-causing blood clot. Clopidogrel bisulfate (Plavix) and ticlopidine hydrochloride (Ticlid) are some common antiplatelet medications. Antiplatelet medications can make you bleed easily — and too much — so take care if you receive a cut or other injury. Always tell doctors if you are taking an antiplatelet medication.
•Blood pressure medications. High blood pressure is a major risk factor for stroke, so people who have had a stroke will likely be put on an antihypertensive (blood pressure lowering) medication to reduce their risk of another stroke if they suffer from high blood pressure. There are many different types of blood pressure medications available, including amlodipine besylate (Norvasc), benazepril (Lotensin), metoprolol (Toprol XL), and ramipril (Altace), and they reduce blood pressure in different ways. Some drugs help by widening blood vessels, others lower heart rate, while still others help to remove unnecessary fluids from the body. Antihypertensives are pretty safe medications, but some people may experience side effects including coughing, dizziness, a lowered heart rate, headaches, impotence, and depression.
•Anticonvulsant medications. When the brain sustains damage after a stroke, seizures are common. To prevent the risk of seizure in a stroke victim, doctors may prescribe an anti-seizure medication, also known as an anticonvulsant. Lorazepam (Ativan), divalproex sodium (Depakote), and phenytoin (Dilantin) are a few commonly prescribed anticonvulsants. Some may have side effects that include stomachache or nausea, weight gain, and sleepiness.
Stroke Treatment: Treat and Prevent
The immediate goal of stroke medication is to restore blood flow to the brain to prevent any further damage. Because patients who have already had one stroke are likely to have another, doctors may prescribe a number of medications to help prevent that from happening. Taking stroke treatment medication is an important part of getting back to good health — and staying there