Treatment of stroke

Written by Dr.Md.Redwanul Huq (Masum)
Monday, 20 June 2011 15:33

[HINTS: Contd-To be continued, M- Month, ±M- Before or After Meal, AM- After Meal, ½HBM- ½ Hour Before Meal,W- Week, D-Day.2HAM- 2 Hour After Meal,bid-Twice daily, tid-Three times daily,qid-Four times daily.]

1. General measurements:

a) Maintenance of airway, breathing and circulation
b) Ensuring adequate nutrition- orally, if not possible -by NG tube feeding along with intravenous
nutrition (if necessary).
c) Posture should be changed 2 hourly
d) Catheterization – if needed
e) Antibiotic eye drop should be used in unconscious patients to prevent exposure keratitis
f) Oral antifungal agents should be used to prevent oral thrush
g) Bed pan can be used to prevent soiling of the cloth

2. Specific treatment of stroke:

i) Treatment of Haemorrhagic stroke
* Tab. Nimodipine 30 mg-2 Tab 6 hourly for 2-3 weeks which should be started within 3-7 days of stroke
* Surgical removal of intracranial hemorrhagic mass.
ii) Treatment of Ischemic stroke
* Antiplatelet Drugs-
Tab. Aspirin (75 mg)
1tab-once daily (AM, usually after launch) —————– contd.
Tab.Clopidogrel (75 mg)
1tab-once daily ( AM, usually after launch) —————– contd.
Tab.Aspirin & Tab.Clopidogrel (75/75 mg) combination
1tab-once daily ( AM, usually after launch) —————– contd.
* rt- PA can be given within 3 hours of onset of an acute ischemic stroke
* Secondary prevention of ischaemic stroke can be done by treating with simvastatin 40 mg daily.

3. Physiotherapy in stroke

Physiotherapy is a significant part of treatment of stroke.
In case of Hemorrhagic stroke- in late period
In case of Ischemic stroke- from early period.

4. Treatment of significant risk factors

a) Treatment of Hyperlipidemia:
I. If Serum Cholesterol  level is high-
Tab. Atorvastatin (10 /20/40 mg)
Tab. Rosuvastatin Calcium(5/10mg)
1 tab-once daily( +M) ———————–contd.
II. If serum Triglyceride level is high-
Cap. Fenofibrate (200 mg)
1 cap-once daily (AM)————————2 /3 M or contd.
Cap. Gemfibrozil(300mg)
1 Cap- once daily/bid ( ½ HBM) ———————2 /3 M or contd.
III. Tab.Trimetazidine (35mg)
1tab-once daily (AM) ————————2 /3 M or contd.
b) Treatment of Diabetes Mellitus:
c) Treatment of Hypertension: Click here.

To know the Generic and Trade names of the above mentioned drugs and their available formulations in Bangladesh click here.

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