Key Terms
STUDY GUIDE
CHAPTER 22 - IN THE STROKE OF TIME PHARMACIST ROLES IN THE MANAGEMENT OF CEREBROVASCULAR ACCIDENT
Stroke
Disease affecting cerebrovascular blood flow; occurs when blood flow to the brain is impeded, causing decreased oxygen,
Know what each half of the goal requires
Community awareness and EMS- hospital coordination for the first half; hospital efficiency and pharmacist involvement fo
Alteplase
Tissue plasminogen activator (tPA); the primary thrombolytic drug used in acute ischemic stroke. Mechanism: dissolves th
Pharmacist role
Help the team select the agent based on renal function (SCr 0.8), cardiac function (EF 45%), and patient-specific factor
Demographics
67-year-old African American woman; retired schoolteacher
PMH
Type 2 diabetes; hyperlipidemia; obesity
Social history
Smokes 1 PPD; no alcohol or drug use; lives with husband; reliable insurance
Home medications
Atorvastatin 20 mg daily; Metformin 1000 mg daily
Initial presentation
Slurred speech; right-sided facial droop; recognized by community pharmacist
Imaging findings
Right MCA/PCA watershed ischemia; right PCA calcified occlusion; proximal right MCA M1 occlusion
Post-thrombectomy
Successful TICI 2B reperfusion; transferred to comprehensive stroke center neurocritical care unit
Stroke etiology
Cardioembolic; new onset atrial fibrillation
Post-stroke labs
LDL 120; HgbA1c 8.1%; EF 45%; SCr 0.8; TSH normal; RPR negative