Drug therapy is a relatively recent approach to the treatment of stroke, and a tremendous amount of research is under way to find effective new drugs that can minimize stroke damage. | Watch Video
Emergency Treatment of Stroke
Much of the damage caused by a thrombotic or embolic stroke occurs in the first six hours. The primary areas of research have focused on the development of new clot-dissolving drugs and medications that make the brain more resistant to stroke (neuroprotective agents).
Drugs that dissolve clots are known as thrombolytic agents. Experimental data and pilot clinical studies suggest that if given within the first few hours after stroke onset, these drugs may dramatically minimize stroke damage.
- Thrombolytic Agents (tissue plasminogen activator [tPA]), widely used to dissolve clots that cause heart attacks, are also effective for dissolving artery-blocking clots in the brain during the critical early stages of stroke. Early administration of tPA after a stroke can reduce neurological damage significantly.
- Neuroprotective Agents - Medications that make the brain less susceptible to the damaging effects of a stroke are called neuroprotective agents. Several of these new drugs are being evaluated in clinical trials now.
A number of medications that help prevent stroke in high-risk patients, particularly those who have had a previous TIA or minor stroke, are being researched. These drugs fall into two major categories: anticoagulants (such as warfarin or ximelgatran) and antiplatelet agents (such as aspirin, dipyridamole and clopidogrel).
A number of other drug therapies are also under investigation.
- Anticoagulants may be given orally or intravenously. These drugs work by thinning the blood and preventing clotting. They are also used for treatment and prevention of deep vein thromboses and pulmonary emboli.
- Antiplatelet Agents work by preventing or reducing the occurrence in the blood-stream of a phenomenon known as platelet aggregation. When there is damage or injury to a blood vessel, platelets (one type of blood particle) migrate to the scene to initiate a healing process. Large numbers of platelets clump together (aggregation) and form what is essentially a plug. This aggregation can sometimes result in formation of a thrombus (blood clot) that may totally block the artery or break loose and block a smaller artery. By preventing this from occurring, antiplatelet agents can reduce the risk of stroke in patients who have had TIAs or prior ischemic strokes. Studies are under way to determine the most effective ways to administer these agents.