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Asian woman taking medicine

As a stroke specialist, I educate patients on  stroke management medication. This includes antiplatelet drugs, anticoagulants, or thrombolytic agents like tissue plasminogen activator (tPA) administered to dissolve blood clots during acute ischemic strokes. There are also medications to manage underlying conditions like hypertension, diabetes, and high cholesterol to minimize the risk of recurrent strokes.

Dr. Manish Taneja

Stroke Specialist, Supreme Vascular and Interventional Clinic

An Overview to Medicine for Stroke

A stroke is always a medical emergency. The longer you go without treatment, the more damage there will be to your brain and the worse the long-term effects will be. Do you know to spot a stroke F.A.S.T.? Stroke symptoms may include the face drooping on one side, weakness or numbness in one arm, or slurred or garbled speech. When somebody has a stroke, healthcare professionals will initiate treatment immediately, typically with medications. Surgery is indicated in some instances.

Understanding the medications given after a stroke can help you or your family have improved knowledge of what is going on as well as potential side effects. Some medications are taken at the time of the stroke, but others may be taken long term. Stroke medications fall into one of six groups.

 

Clot-Busting Drugs (tPA)

The root cause of most strokes is a blood clot blocking oxygen supply to the brain. Clot-busting drugs or thrombolytics are used right away and must be started within 4.5 hours of the stroke. Thrombolytics such as tPA (tissue plasminogen activator) are known as clot busters. However, before they are administered, a brain scan has to be done. Thrombolytics treat ischemic strokes but can make hemorrhagic strokes, where bleeding is happening in the brain, worse.

The most common medication used is alteplase. This is given as an infusion and it works by converting plasminogen, which forms clots, to an enzyme that can then be cleared from the body. The infusion can take as long as an hour. Alteplase can increase bleeding and patients with high blood pressure or advanced age are at highest risk. Alteplase should not be used in people with internal bleeding or a recent head injury.

Antiplatelet Drugs

Antiplatelet drugs are used to treat both strokes and transient ischemic attacks (mini strokes). These drugs work by reducing the formation of platelets and/or making it harder for them to stick together (aggregate) to form clots. These drugs also make hemorrhagic strokes worse so, again, a brain scan is done to establish what kind of stroke the person had. The most common antiplatelet drugs used are aspirin, aspirin-dipyradamole, and ticagrelor. Aspirin is commonly used as it is both effective and cheap, but combining it with dipyradamole appears to have increased benefits. Aspirin and clopodigrel are also used for short term therapy, but shows no benefit for long-term prevention of future vascular events and may increase bleeding risk.

Some patients may stay on antiplatelet drugs permanently to reduce the risk of another stroke. Antiplatelet are the first kind of blood thinner drugs and the second one is called anticoagulants.

Anticoagulants

Evidence shows that anticoagulants have limited benefit for treatment of acute stroke. They are, however, used to prevent stroke in patients with atrial fibrillation and may be recommended to prevent future strokes. Anticoagulants should not be taken within four days of an alteplase infusion (the two can work together to cause bleeding).

Anticoagulant drugs prevent clots from forming. Heparin is the most common drug used, and is not indicated for all patients, including people with kidney and/or liver disease. However, when they are suitable, they can decrease the risk of stroke by over two-thirds.

Blood Pressure Medication

High blood pressure can increase the risk of stroke substantially. In fact, most people who have strokes have high blood pressure. If you have been diagnosed with hypertension, you need to take your medication. In some cases, high blood pressure is detected only after a stroke or TIA occurs. A variety of high blood pressure medications may be prescribed. These include diuretics to help your body clean out sodium and water, beta blockers to reduce heart rate, ACE inhibitors, which help blood vessels relax, angiotensin II receptor blockers, which prevent them from narrowing, and calcium channel blockers, which keep calcium out of your heart and arteries.

If you have high blood pressure, taking your medication as prescribed helps keep you from having a stroke, whether or not you have already had one.

Cholesterol Lowering Drugs

High cholesterol causes stiffening of blood vessels, called atherosclerosis. This encourages the development of clots, which can then cause a stroke. High cholesterol is very common and can be managed with diet changes and drugs called statins, that lower cholesterol. If you have had a stroke, your doctor will look at your cholesterol levels and decide if you need statin drugs.

Diabetes Management Medication

Diabetes causes changes to blood vessels, including cerebral blood vessels, and can also make it harder to recover from a stroke. If you have diabetes, you should be working with a nutritionist to help keep your blood sugar down and your diet healthy, and get sufficient exercise. Controlling diabetes helps you prevent strokes and prevent strokes from recurring. Metformin is the most common medication prescribed for diabetes. It increases your body’s sensitivity to insulin, allowing your body to make better use of less insulin, and decreases the glucose absorbed from food. This, in turn, reduces the damage done to blood vessels.

World-Class Stroke Treatment and Care at Supreme Vascular and Interventional Clinic

If you have had a stroke or are at high risk of having a stroke, you need to keep taking your medication, especially medication to control high blood pressure, high cholesterol, or diabetes.

Work with your healthcare provider to make sure you are taking the right medication and also keeping up with recommended lifestyle changes such as reducing consumption of sugar or fat. If you have had a stroke in Singapore, our compassionate stroke specialist, Dr. Manish Taneja, in Singapore can help you manage things so it does not recur. We invite you to contact us for an appointment today.

Your Guide to Prevent a Second Stroke

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Boost Your Recovery with Specialized Stroke Treatment in Singapore

While stroke may be devastating, the support of loved ones and a specialized stroke clinic in Singapore like Supreme Vascular and Interventional Clinic is by your side. We offer personalized guidance and support to accelerate your recovery from stroke. Schedule a consultation with our stroke specialist, Dr. Manish Taneja, to take the next step in your stroke healing and recovery journey with our stroke screeningmanagement, and prevention programs.

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Imagine heart attacks where the blood flow to your heart is blocked. Similarly, a stroke occurs when the blood flow to your brain is interrupted becoming a “brain attack”. When blood supply does not reach a certain part, brain cells begin to die. Different types of stroke include ischemic strokes (blockage of blood vessel due to blood clot) or a mini stroke, a TIA (transient ischemic attack), with no permanent damage yet serious. Stroke also occurs when a blood vessel in the brain pops causing bleeding in the brain.

Certain areas of the brain can be affected by stroke and some symptoms of a stroke including cardiovascular disease, diabetes, and high blood sugar levels increase the risk of stroke whereas an active lifestyle or controlling high cholesterol reduces the risk. How well do you know stroke? Find tips to prevent and manage stroke, the differences in stroke screening tests, and the newer technology and treatments available. Come in for an easy consultation and further evaluation with our stroke specialist in Singapore at the Supreme Vascular and Interventional Clinic. 

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Neurointerventional / Stroke Treatments

The Supreme Vascular and Interventional Clinic is your “go-to” facility for various neurointerventional / stroke conditions and treatments. To arrange an appointment with Dr. Manish Taneja, our neurointervention specialist, contact us. You can also call us at (+65) 6904 8084 for a consultation.