ASC Stroke Pharmacotherapy & Medication Management Flashcards
6 cards from real ASC practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 6 ASC Stroke Pharmacotherapy & Medication Management flashcards as text
Tenecteplase is an alternative thrombolytic to alteplase. What is its primary administration advantage in acute ischemic stroke?
Answer: Single IV bolus dose rather than bolus plus 60-minute infusion
Tenecteplase is administered as a single IV weight-based bolus, simplifying workflow compared to alteplase's 60-minute infusion protocol.
Which medication used in acute stroke management requires monitoring for hypoglycemia as a complication that can worsen neurological outcomes?
Answer: Insulin for hyperglycemia management
Insulin is used to treat post-stroke hyperglycemia, but over-correction causing hypoglycemia is associated with worsened neurological outcomes and must be avoided.
A patient on warfarin with INR 3.5 presents with acute ischemic stroke within the tPA window. What is the correct action?
Answer: tPA is contraindicated; proceed with evaluation for mechanical thrombectomy if eligible
An INR > 1.7 is a contraindication to IV tPA; the patient should be evaluated urgently for mechanical thrombectomy as an alternative.
What is the primary purpose of administering 3% hypertonic saline or mannitol in the setting of malignant cerebral edema after ischemic stroke?
Answer: Reduce intracranial pressure by osmotic extraction of cerebral water
Hyperosmolar agents create an osmotic gradient that draws water from brain tissue into the vasculature, thereby reducing intracranial pressure.
Which antiseizure medication is recommended as first-line treatment for new-onset seizures occurring after ischemic stroke?
Answer: Levetiracetam or lacosamide
Levetiracetam and lacosamide are preferred first-line IV antiseizure medications for post-stroke seizures due to their favorable safety and drug interaction profiles.
A stroke coordinator reviews a patient's medication reconciliation and notes the patient takes apixaban for AF. The patient presents with acute ischemic stroke 8 hours after last dose. What pharmacologic consideration applies?
Answer: IV tPA is generally contraindicated if last DOAC dose was within 48 hours without reversal agent
IV tPA is contraindicated in patients on DOACs unless levels can be confirmed to be in safe range; recent dosing within 48 hours is generally a contraindication.