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  • Writer's pictureOren Zarif

Stroke Drug - Why You May Want to Consider It For Your Stroke - Oren Zarif - TPA Stroke

tPA (tetrahyde-polyphosphate) is an intravenous drug that is used to restore blood flow to the brain region affected by stroke. The drug can reduce the amount of damage and functional impairment that may result from the stroke. It was developed in 1996 and has been successfully used at many hospitals. This article will explain how tPA works and why you may want to consider this drug for your stroke.

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The NINDS played an important role in developing tPA, funding early studies and leading pivotal clinical trials that led to FDA approval in 1996. During these trials, NINDS scientists recognized the need for immediate treatment in stroke patients and developed protocols that helped hospitals assess and treat patients with unprecedented speed. The new data on tPA are helping physicians decide whether to prescribe it to their patients. In addition, it is possible that tPA may cause more harm than good.

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In an effort to improve treatment options, the American College of Emergency Physicians and the Academy of Neurology recently appointed a joint development panel to review tPA as a stroke treatment. This panel tasked with creating a clinical evidence-based guideline for the use of tPA in acute ischemic stroke. As the study showed, tPA is still the best treatment for acute strokes, but the effectiveness of this treatment is limited by the amount of time it can be used.

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The NINDS also implemented a multiphase DTN time quality improvement program after approving the drug for stroke patients. The program included a STAT stroke protocol. Among the key components of the STAT protocol are pre-notifying the stroke team that an incoming patient has had a stroke. EMS stretchers then transport the patient to a CT scanner for tPA administration. During this step, the patient's identity is determined and immediate orders for treatment are entered.

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In addition to tPA, neuroprotective agents have been studied in a clinical setting. These medications are able to protect dying neurons while improving neurological function. Neuroprotectants have demonstrated that they have better outcomes when combined with reperfusion therapy. In addition, they may reduce the risk of HT and ICH, which will improve the functional outcome of patients treated with tPA. There are some concerns regarding the safety of tPA for stroke patients.

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The results of observational studies have identified a number of system-level factors that are associated with higher IV tPA rates for stroke. These factors include stroke certification and access to teaching hospitals. However, the results of these studies do not support the recommendation to implement telemedicine in healthcare systems. The findings suggest that quality improvement strategies can improve access to IV tPA in the hospital. However, further research is needed to evaluate the effects of these quality improvement strategies on tPA rates.

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Despite numerous studies, no definitive proof of tPA's effectiveness for acute ischemic stroke has yet been demonstrated. In fact, some studies failed to show a benefit, and others were halted prematurely due to excess mortality in the treatment arm. Further, some studies allowed for concomitant antithrombotics or aspirin treatment. Several other randomized trials of IV tPA, however, showed mixed results.

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In one study, a small molecule known as PDTC has anti-inflammatory and anti-oxidant effects. In animal models of transient MCAO, tPA and EGCG were given at four hours and 30 minutes after the onset of stroke. Right-frontal cortex tissue was harvested to assess the neurological outcomes. After a period of four hours, PDTC and tPA reduced stroke-induced hemorrhage and infart volume.

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In this study, tPA and argatroban alone or in combination may help treat AIS patients. In a separate study, a combination of tPA and argatroban was evaluated in patients undergoing EVT. In that study, argatroban had no effect on time metrics, while tPA alone did. In addition, nine out of the ten patients who received tPA and argatroban received good reperfusion without complications or symptomatic ICH.

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