Stroke

Drugs for Emergency Care

Much of the damage caused by a thrombotic or embolic stroke occurs in the first few hours after the event. Research has focused primarily on the development of new clot-dissolving drugs and medications (neuroprotective agents) that make the brain more resistant to stroke.

Medications 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.

Several promising treatment approaches include:

• Thrombolytic agents
  Tissue plasminogen activator [tPA], widely used to dissolve clots that cause heart attacks, is now being used to dissolve artery-blocking clots in the brain during the critical early stages of stroke. Administration of tPA early after a stroke reduces neurological damage significantly. The drug is most effective when administered within the first three hours of stroke onset but is being tested at Stanford for selected patients up to six hours after stroke onset.
• 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.

It is not yet known which stroke patients are the best candidates for these neuroprotective drugs or whether the drugs will be consistently effective. The medications are investigational and authorized by the FDA for use only in randomized clinical trials. As a result, not every eligible emergency stroke patient will be able to receive them.