Intracranial hemorrhage medical therapy
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Intracranial hemorrhage Microchapters |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Sahar Memar Montazerin, M.D.[2]
Overview
Medical Therapy
Pharmacologic therapy in patients with intracranial hemorrhage include:[1]
- Hemostatic therapy to correct the underlying coagulopathies. Agents that can be used to achieve this goal may differ based on the oral anticoagulant agent which resulted in the bleeding complications.
- The following agents can be used for warfarin reversal:[2][3][4]
- Fresh Frozen Plasma (FFP)
- Prothrombin Complex Concentrates (PCCs)
Contraindicated medications
Intracranial hemmorhage is considered an absolute contraindication to the use of the following medications:
- Amyl nitrite
- Cilostazol
- Clopidogrel
- Pentoxifylline
- Prasugrel
- Ticagrelor
- Ticlopidine
- Vorapaxar
- Mannitol
References
- ↑ Caceres, J. Alfredo; Goldstein, Joshua N. (2012). "Intracranial Hemorrhage". Emergency Medicine Clinics of North America. 30 (3): 771–794. doi:10.1016/j.emc.2012.06.003. ISSN 0733-8627.
- ↑ Steiner, Thorsten; Rosand, Jonathan; Diringer, Michael (2006). "Intracerebral Hemorrhage Associated With Oral Anticoagulant Therapy". Stroke. 37 (1): 256–262. doi:10.1161/01.STR.0000196989.09900.f8. ISSN 0039-2499.
- ↑ Goldstein, Joshua N.; Thomas, Stephen H.; Frontiero, Virginia; Joseph, Annelise; Engel, Chana; Snider, Ryan; Smith, Eric E.; Greenberg, Stephen M.; Rosand, Jonathan (2006). "Timing of Fresh Frozen Plasma Administration and Rapid Correction of Coagulopathy in Warfarin-Related Intracerebral Hemorrhage". Stroke. 37 (1): 151–155. doi:10.1161/01.STR.0000195047.21562.23. ISSN 0039-2499.
- ↑ Holland, Lorne; Warkentin, Theodore E.; Refaai, Majed; Crowther, Mark A.; Johnston, Marilyn A.; Sarode, Ravindra (2009). "Suboptimal effect of a three-factor prothrombin complex concentrate (Profilnine-SD) in correcting supratherapeutic international normalized ratio due to warfarin overdose". Transfusion. 49 (6): 1171–1177. doi:10.1111/j.1537-2995.2008.02080.x. ISSN 0041-1132.