Đang chuẩn bị liên kết để tải về tài liệu:
Vascular neurology questions and answers - part 3

Ancrod là một đại lý fibrinolytic xuất phát từ nọc độc của pit viper Malaysia. A, kích đúp mù thử nghiệm ngẫu nhiên đã được báo cáo vào năm 2000. Đại lý này giảm số lượng bệnh nhân tàn tật nghiêm trọng, không có tăng hoặc giảm tỷ lệ tử vong. Tỷ lệ có triệu chứng xuất huyết nội sọ là 5,2 | PHARMACOLOGY ANSWERS 53 103. The answer is E. No evidence suggests that any of these agents as well as hyperventilation reduces ICP or improves outcome in patients with ischemic brain swelling. Adams 104. The answer is C. Ancrod is a fibrinolytic agent derived from the venom of the Malaysian pit viper. A double-blinded randomized trial was reported in 2000. This agent decreased the number of severely disabled patients with no increase or decrease in mortality. The symptomatic intracranial hemorrhage rate was 5.2 lower than in the National Institute of Neurological Disorders and Stroke NINDS t-PA trial published in 1995. Fibrinogen levels continue to decrease to their lowest within 12 to 24 hours. Unfortunately there were administrative issues including change in the ownership of the company that developed the drug to the clinical trial stage which interfered with FDA approval and the availability of the agent. A new company was formed and obtained the snake farm. FDA issues are being dealt with and a follow-up clinical trial is ongoing. The initial trial studied 0 to 3 hours but the new trial will study later time points in an attempt to increase the duration of the acute treatment window. The European Stroke Treatment with Ancrod Trial ESTAT l did not show a positive result with An-crod treatment but the majority of the patients in the trial were treated within between 3 to 6 hours. Sherman JAMA 2000 105. The answer is D. The Vitamin Intervention for Stroke Prevention VISP study was a secondary stroke prevention trial that included patients who had suffered a nondisabling stroke. High or low doses of folic acid pyridoxine vitamin B6 and cobalamin vitamin B12 were given to lower total homocysteine levels in 3 680 adults. Although high-dose vitamins lowered homocysteine levels more than did low-dose vitamins no difference was observed in the effect on vascular outcome. A more recent efficacy analysis suggested that there may be some benefit to high-dose treatment in