Stroke Assessment
Study online at https://quizlet.com/_h55kvh
Major non-modifiable risk factors for Age, Heredity, Race, Female gender, Pri-
stroke or stroke/MI
HTN, DM, Hyperlipidemia, Smoking,
Major modifiable risk factors for stroke
Atrial fibrillation
BE FAST (Balance, Eyes, Face, Arms,
Stroke symptom mnemonic
Speech, Time)
Initial goal when stroke suspected Reverse mimics, rule out hemorrhage
Time window for IV fibrinolytics 3 to 4.5 hours from last known well
Time window for mechanical thrombec-
<24 hours from last known well
tomy
NIHSS score most likely to benefit from
>10
fibrinolytics
Blood pressure cutoff to give fibrinolytics <185/110 mmHg
First line medication to lower BP before
Labetalol bolus
fibrinolytics
Second option for BP control if labetalol
Nicardipine or Clevidipine infusion
fails
NIHSS, Glucose, Head CT negative,
Checklist for fibrinolytic eligibility Last known well <4.5 hrs, BP control,
Weight, Med list, No anticoagulants
Lab criteria to give fibrinolytics if on war-
INR <1.7, PT <15 sec, aPTT <40
farin
Weight dosing, medication verification,
Role of pharmacist in stroke team assist assessment, prepare thrombolyt-
ics
Alteplase dosing 0.9 mg/kg (max 90 mg)
10% bolus over 1 min, remainder infu-
Alteplase administration
sion over 60 min
0.25 mg/kg as single IV bolus (max 25
Tenecteplase dosing
mg)
Advantage of tenecteplase over al-
Single bolus, no continuous infusion
teplase
1/2
Study online at https://quizlet.com/_h55kvh
Major non-modifiable risk factors for Age, Heredity, Race, Female gender, Pri-
stroke or stroke/MI
HTN, DM, Hyperlipidemia, Smoking,
Major modifiable risk factors for stroke
Atrial fibrillation
BE FAST (Balance, Eyes, Face, Arms,
Stroke symptom mnemonic
Speech, Time)
Initial goal when stroke suspected Reverse mimics, rule out hemorrhage
Time window for IV fibrinolytics 3 to 4.5 hours from last known well
Time window for mechanical thrombec-
<24 hours from last known well
tomy
NIHSS score most likely to benefit from
>10
fibrinolytics
Blood pressure cutoff to give fibrinolytics <185/110 mmHg
First line medication to lower BP before
Labetalol bolus
fibrinolytics
Second option for BP control if labetalol
Nicardipine or Clevidipine infusion
fails
NIHSS, Glucose, Head CT negative,
Checklist for fibrinolytic eligibility Last known well <4.5 hrs, BP control,
Weight, Med list, No anticoagulants
Lab criteria to give fibrinolytics if on war-
INR <1.7, PT <15 sec, aPTT <40
farin
Weight dosing, medication verification,
Role of pharmacist in stroke team assist assessment, prepare thrombolyt-
ics
Alteplase dosing 0.9 mg/kg (max 90 mg)
10% bolus over 1 min, remainder infu-
Alteplase administration
sion over 60 min
0.25 mg/kg as single IV bolus (max 25
Tenecteplase dosing
mg)
Advantage of tenecteplase over al-
Single bolus, no continuous infusion
teplase
1/2
