New Drugs for Stroke
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.
The Stanford Stroke Center is participating in FDA-approved clinical trials of a number of new drugs, which are showing promise for both emergency treatment of stroke as well as stroke prevention.
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 at Stanford.
Stroke Prevention
A number of medications that help prevent stroke in high-risk patients, particularly those who have had a previous TIA or minor stroke, are under investigation at the Stanford Stroke Center. These drugs fall into two major categories: anticoagulants (such as warfarin or ximelgatran) and antiplatelet agents (such as aspirin, dipyridamole and clopidogrel).
- 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 at Stanford to determine
the most effective ways to administer these agents.
A number of other drug therapies are also under investigation at Stanford. The development of effective preventive medications will continue to be a major goal of the Stanford Stroke Center.
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New Ways to Diagnose Stroke and Stroke Risk
