HEALTHNET

Stroke - a silent killer? (Part 2)

Several post-stroke medications are introduced in the following passage.

(Posted on 26 April 2007)

Any patient suffered from a prior stroke has a higher risk to develop stroke again, therefore post stoke prevention is emphasized during rehabilitation. Any known risk factors like high blood pressure, smoking, diabetes mellitus etc. should be controlled or eliminated if possible. Several post-stroke medications are introduced in the following passage.

1. Aspirin
Aspirin is a well-known anti-platelet drug that reduces the platelet to aggregate and form clots in blood vessel. Dosage ranges from 75mg to 325mg daily. Since long term administration may lead to side effects like gastric upset, ulcer or even bleeding, patients can take it with food, use enteric coated aspirin or co-administrate with gastric acid reducer like famotidine.

2. Ticlopidine
Ticlopidine used to be a new hope in preventing stroke recurrence. However, its use is limited because of severe adverse drug reaction reported which greatly reduce the platelet count in a number of patients. Ticlopidine is nowadays replaced by clopidogrel.

3. Clopidogrel
Clopidogrel is another common drug used in stoke prevention and deep vein thrombosis. The recommended dosage is 75mg daily. Clopidogrel is suitable for patients whom are allergy to aspirin, poor toleration to aspirin and have history of aspirin induced gastric bleeding.

4. Dipyridamole
Combination of dipyridamole and aspirin is proven to further reduce the risk of stroke recurrence. Common dosage used is 75 to 225 mg daily.

5. Warfarin
Warfarin is also known as "Blood thinner" which is a commonly prescribed anticoagulant. Since its dosage is individualized, when the patient starts to receive warfarin the doctor will closely monitor the response of the medication and doses will be adjusted in order to reach the target level. Usually this process may take a few weeks or months to finish. Once the patient is stabilized, he or she should follow the instruction to continue the medication and receive blood tests accordingly. Since Vitamin K works against warfarin, therefore daily vitamin K consumption should be kept regular to avoid fluctuation. Foods high in vitamin K like green leaf vegetables and milk powder should be avoided in huge quantity. Common dosage of warfarin goes from 2 to 5 mg daily.

Source: Hong Kong and Drug Education Resources Centre, The Society of Hospital Pharmacists of Hong Kong