Document Type : Original Article

Authors

Department of Pharmaceutics, Smt. Sarojini Ramulamma College of Pharmacy, Palamuru University, Seshadri Nagar, Mahabubnagar District, Telangana State, India

Abstract

The occurrence of an ischemic stroke arises from the unfortunate circumstance in which a blood vessel becomes impeded or obstructed, resulting from the presence of a clot, atherosclerosis, or the narrowing of arteries. The neurology department of a 300-bed, multi-specialty tertiary teaching hospital was the site of this six-month observational study. Prescriptions for both inpatients and outpatients in the neurology unit, totalling 90, are considered according to the inclusion criteria. Patient case sheets, questionnaires, interviews, biomedical and radiological reports, and drug regimen charts are the main data sources. Acute ischemic stroke (AIS) patients are more prevalent in the over-60 age group than in the 20–35 age group. The information obtained indicates that male patients have greater effects than female ones. Furthermore, our research indicates that AIS is more common in obese and overweight people. One of the main risk factors for developing AIS is alcohol drinking, tobacco chewing, and smoking, which affect most AIS patients. Treatment options for acute ischemic stroke (AIS) include intravenous thrombolytic therapy (IVT), anti-platelet therapy, anticoagulant therapy, and adjuvant therapies using statins and drugs based on the comorbidities of the patients. This research highlights that individuals with AIS have shown higher progress when physical rehabilitation is combined with intravenous thrombolytic treatment (IVT) for patients with comorbidities. We found that the individuals who continued taking their medicine and therapy after their discharge from the hospital had better motor strength than those who stopped. Our study concludes that the integration of pharmacotherapy with physical rehabilitation yielded significant enhancements in the functional capacity of individuals affected by stroke.

Graphical Abstract

An outlook study on the combination of pharmacotherapy and physical rehabilitation for clinically significant acute ischemic stroke patients

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Main Subjects

Selected author of this article by journal

Dr. poluri koteswari
Smt Sarojini Ramulamma College of Pharmacy

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  1. Simonsen SA, West AS, Heiberg AV, Wolfram F, Jennum PJ, Iversen HK (2022) Is the TOAST classification suitable for use in personalized medicine in ischemic stroke? Journal of Personalized Medicine 12 (3): 496. doi: https://doi.org/10.3390/jpm12030496
  2. Montaño A, Hanley DF, Hemphill JC (2021) Chapter 13 - Hemorrhagic stroke. In: Hetts SW, Cooke DL (eds) Handbook of Clinical Neurology, vol 176. Elsevier, pp 229-248. doi:https://doi.org/10.1016/B978-0-444-64034-5.00019-5
  3. Ntaios G (2020) Embolic stroke of undetermined source: JACC review topic of the week. Journal of the American College of Cardiology 75 (3): 333-340. doi: https://doi.org/10.1016/j.jacc.2019.11.024
  4. Yamunadevi A, Sulaja S (2016) Old Age Mortality in India–An Exploration from Life Expectancy at Age 60. International Journal of Asian Social Science 6 (12): 698-704. doi: https://doi.org/10.18488/journal.1/2016.6.12/1.12.698.704
  5. Chobe M, Chobe S, Dayama S, Singh A, Metri K, Basa JR, Raghuram N, Singh Sr A, Raghuram N (2022) Prevalence of Non-Communicable Diseases and Its Associated Factors Among Urban Elderly of Six Indian States. Cureus 14 (10): e30123. doi: https://doi.org/10.7759%2Fcureus.30123
  6. Jones SP, Baqai K, Clegg A, Georgiou R, Harris C, Holland E-J, Kalkonde Y, Lightbody CE, Maulik PK, Srivastava PM (2022) Stroke in India: A systematic review of the incidence, prevalence, and case fatality. International Journal of Stroke 17 (2): 132-140. doi: https://doi.org/10.1177/17474930211027834
  7. Campbell BC, De Silva DA, Macleod MR, Coutts SB, Schwamm LH, Davis SM, Donnan GA (2019) Ischaemic stroke. Nature reviews Disease primers 5 (1): 70. doi: https://doi.org/10.1038/s41572-019-0118-8
  8. Berkhemer OA, Fransen PS, Beumer D, Van Den Berg LA, Lingsma HF, Yoo AJ, Schonewille WJ, Vos JA, Nederkoorn PJ, Wermer MJ (2015) A randomized trial of intraarterial treatment for acute ischemic stroke. New England Journal of Medicine 372 (1): 11-20. doi: https://doi.org/10.1056/nejmoa1411587
  9. Albers GW, Marks MP, Kemp S, Christensen S, Tsai JP, Ortega-Gutierrez S, McTaggart RA, Torbey MT, Kim-Tenser M, Leslie-Mazwi T (2018) Thrombectomy for stroke at 6 to 16 hours with selection by perfusion imaging. New England Journal of Medicine 378 (8): 708-718. doi: https://doi.org/10.1056/nejmoa1713973
  10. Lisabeth LD, Brown DL, Hughes R, Majersik JJ, Morgenstern LB (2009) Acute stroke symptoms: comparing women and men. Stroke 40 (6): 2031-2036. doi: https://doi.org/10.1161/STROKEAHA.109.546812
  11. Turc G, Maïer B, Naggara O, Seners P, Isabel C, Tisserand M, Raynouard I, Edjlali M, Calvet D, Baron J-C (2016) Clinical scales do not reliably identify acute ischemic stroke patients with large-artery occlusion. Stroke 47 (6): 1466-1472. doi: https://doi.org/10.1161/STROKEAHA.116.013144
  12. Yousufuddin M, Young N (2019) Aging and ischemic stroke. Aging (Albany NY) 11 (9): 2542. doi: https://doi.org/10.18632%2Faging.101931
  13. Rexrode KM, Madsen TE, Yu AY, Carcel C, Lichtman JH, Miller EC (2022) The impact of sex and gender on stroke. Circulation research 130 (4): 512-528. doi: https://doi.org/10.1161/CIRCRESAHA.121.319915
  14. Horn JW, Feng T, Mørkedal B, Strand LB, Horn J, Mukamal K, Janszky I (2021) Obesity and risk for first ischemic stroke depends on metabolic syndrome: the HUNT study. Stroke 52 (11): 3555-3561. doi: https://doi.org/10.1161/STROKEAHA.120.033016
  15. She R, Yan Z, Hao Y, Zhang Z, Du Y, Liang Y, Vetrano DL, Dekker J, Bai B, Lau JT (2022) Comorbidity in patients with first-ever ischemic stroke: Disease patterns and their associations with cognitive and physical function. Frontiers in Aging Neuroscience 14: 887032. doi: https://doi.org/10.3389/fnagi.2022.887032
  16. Goyal M, Ospel J (2020) Challenges to stroke care 5 years after endovascular therapy became the standard. The Lancet Neurology 19 (3): 210-211. doi: https://doi.org/10.1161/STR.0000000000000211
  17. Aiyagari V, Gorelick PB (2009) Management of blood pressure for acute and recurrent stroke. Stroke 40 (6): 2251-2256. doi: https://doi.org/10.1161/STROKEAHA.108.531574
  18. Kersten C, Knottnerus I, Heijmans E, Haalboom M, Zandbergen A, den Hertog H (2022) Effect of metformin on outcome after acute ischemic stroke in patients with type 2 diabetes mellitus. Journal of Stroke and Cerebrovascular Diseases 31 (9): 106648. doi: https://doi.org/10.1016/j.jstrokecerebrovasdis.2022.106648
  19. Sandercock PA, Counsell C, Tseng MC, Cecconi E (2014) Oral antiplatelet therapy for acute ischaemic stroke. Cochrane Database of Systematic Reviews(3). doi: https://doi.org/10.1002/14651858.CD000029.pub3
  20. Paciaroni M, Agnelli G, Falocci N, Tsivgoulis G, Vadikolias K, Liantinioti C, Chondrogianni M, Bovi P, Carletti M, Cappellari M (2017) Early Recurrence and Major Bleeding in Patients With Acute Ischemic Stroke and Atrial Fibrillation Treated With Non–Vitamin‐K Oral Anticoagulants (RAF‐NOAC s) Study. Journal of the American Heart Association 6 (12): e007034. doi: https://doi.org/10.1161/JAHA.117.007034
  21. Johnston SC, Easton JD, Farrant M, Barsan W, Conwit RA, Elm JJ, Kim AS, Lindblad AS, Palesch YY (2018) Clopidogrel and aspirin in acute ischemic stroke and high-risk TIA. New England Journal of Medicine 379 (3): 215-225. doi: https://doi.org/10.1056%2FNEJMoa1800410
  22. Langhorne P, Wu O, Rodgers H, Ashburn A, Bernhardt J (2017) A Very Early Rehabilitation Trial after stroke (AVERT): a Phase III, multicentre, randomised controlled trial. Health Technology Assessment 21 (54): 1-119. doi: https://doi.org/10.3310/hta21540