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 minsword 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
ANTITHROMBOTIC AGENTS

PLATELET INHIBITORS

ANTICOAGULANTIA
NEUROPROTECTION

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

Activation of plasminogen by
fibrinolytic agents

ANTITHROMBOTIC 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

 A comparison
of
streptokinase
and alteplase.

 Degradation Of an
unwanted
thrombus And a
beneficial
hemostatic p lug
by plasminogen
actlvators.

Mechanismof action of streptokinase