Early Acute Ischemic Stroke Management for Pharmacists

Approximately 795 000 people in the United States experience stroke annually, with 610 000 initial and 185 000 recurrent events.1 The majority of these events (87%) are ischemic in nature.1 Stroke ranks fifth among all causes of death in the United States, although rates of mortality due to stroke have decreased overall by 2.3% between 2005 and 2015.1 Given the aging population of the United States, it is likely that the incidence of stroke will continue to rise. The management of patients with acute ischemic stroke (AIS) continues to evolve, with the recent publication of several trials evaluating fibrinolytic, interventional, and medical management of critically ill patients presenting with occlusions of the cerebral vasculature. Recently published American Heart Association and American Stroke Association (AHA/ASA) guidelines on the early management of these patients have provided updated recommendations for a variety of pharmacotherapeutic interventions for the treatment of AIS.2 The primary focus of this article will be the early pharmacologic management of patients presenting with AIS. Pharmacists should be aware of medical and surgical interventions available to patients presenting with AIS to effectively manage and monitor therapy.