The stroke pharmacopeia: current medical therapies

Drug therapies that inhibit or reverse thrombus formation are important components of the management of acute ischemic stroke. The role of antiplatelet and anticoagulant therapies in stroke prevention has been defined, but further research is needed to confirm the possible benefits of aspirin, heparin, and low-molecular-weight heparin products in acute ischemic stroke. Recently, double-blind, placebo-controlled studies have evaluated the role of the thrombolytic agents streptokinase and tissue plasminogen activator (t-PA) in patients with acute ischemic stroke. Intravenous t-PA, administered within 3 hours of symptom onset at a dose of 0.9 mg/kg, is safe and effective in carefully selected patients.