TheABCsofSecondaryStrokePrevention：卒中二级预防的基本知识共16页
合集下载
- 1、下载文档前请自行甄别文档内容的完整性，平台不提供额外的编辑、内容补充、找答案等附加服务。
- 2、"仅部分预览"的文档,不可在线预览部分如存在完整性等问题,可反馈申请退款(可完整预览的文档不适用该条件!)。
- 3、如文档侵犯您的权益，请联系客服反馈,我们会尽快为您处理(人工客服工作时间：9:00-18:30)。
A Guideline For Healthcare Professionals from the American Heart Association/American Stroke Association Dr. Jane Morris and Dr. John Belden, stroke experts, MMP Neurology: 207-883-1414 My expert Nurse Practitioner Colleagues at MMP Neurology: Georgeann Dickey Jason Aucoin Diana Page
Age? • Recommend reversal after ICH, SAH, SDH,
Consider resuming after 1-2 weeks
Atrial Fibrillation:
• Atrial Fibrillation • 2.7 Million Americans have Afib! • Afib is associated with a 5-fold increase in
May 1, 2019
Welcome to the MNPA 2019 Conference
• It is a distinct honor to present to you, my esteemed peers!
Disclosures
• I am employed by Maine Medical Partners Neurology and Maine Medical Center, Dept. of Medicine
Anticoagulation Post- Ischemic- Stroke • 2.Blood pressure goals post-stroke • 3. Diabetes management goals post-stroke • 4. Cholesterol goals post-stroke • 5. Brief overview of new anticoagulation agents in
The End
• Thank You and Enjoy the Conference! • Chris Shaffer, FNP-BC, MS-N • Maine Medical Partners Neurology • Email:
谢谢！
16
Drugs, Fats, and Alcohol:
• Hyperlipidemia: • LDL should be <100, ideally <70 (if CHD, severe
stenosis, DM) • Obesity: BMI>30 increases stroke risk (duh) • Quit tobacco and secondary exposure • ETOH- the J curve
The ABCs of
Secondary Stroke
Prevention
Chris Shaffer, FNP MMP Neurology/MMC Inpatient Neurology Consult Service Maine Nurse Practitioner Association Annual Conference
stroke risk • 15% of all strokes are from Afib.
Hypertห้องสมุดไป่ตู้nsion
• Hypertension: • 72 Million Americans (2019) have HTN: >140/90 • ACEI/ARB + thiazide diuretic most protective
patients?
Womens’ Issues:
• It’s a girl thing:
• 9 Million women die each year from heart disease worldwide
• Pregnancy and cancer are pro-thrombotic states and we often overlook s/sx TIA and stroke in those populations
Monday Morning Call
• You are notified that a patient of yours is being discharged form the hospital after having an ischemic stroke.
• When should you schedule this follow-up appointment?
addition to warfarin (pharmacology update)
Antiplatelet Therapy
• Is Aspirin really enough? 81 vs 325 mg vs more? Does ASA fail?
Anticoagulation
• Indications: • Atrial Fibrillation- the elusive arrhythmia • PFO- what to do? ASA? Atrial septal aneurysm?
against stroke • What SHOULD the ideal BP be in your post-
stroke patient?
Diabetes:
• Diabetes: • 25.8 Americans have Diabetes. • What should the HbA1C be for post-stroke
• What will you address at this visit?
What Lab Tests Are Important?
• Bmp vs cmp • FLP • HbA1C
• When? Why? How often?
Clinical Resources
• AHA/ASA Get With The Guidelines • : Guidelines for the Prevention of Stroke in Patients With Stroke or Transient Ischemic Attack:
• I have no financial interest in any of the information presented today
Objectives
• Participants will understand: • 1. Indications for Antiplatelet therapy and
Age? • Recommend reversal after ICH, SAH, SDH,
Consider resuming after 1-2 weeks
Atrial Fibrillation:
• Atrial Fibrillation • 2.7 Million Americans have Afib! • Afib is associated with a 5-fold increase in
May 1, 2019
Welcome to the MNPA 2019 Conference
• It is a distinct honor to present to you, my esteemed peers!
Disclosures
• I am employed by Maine Medical Partners Neurology and Maine Medical Center, Dept. of Medicine
Anticoagulation Post- Ischemic- Stroke • 2.Blood pressure goals post-stroke • 3. Diabetes management goals post-stroke • 4. Cholesterol goals post-stroke • 5. Brief overview of new anticoagulation agents in
The End
• Thank You and Enjoy the Conference! • Chris Shaffer, FNP-BC, MS-N • Maine Medical Partners Neurology • Email:
谢谢！
16
Drugs, Fats, and Alcohol:
• Hyperlipidemia: • LDL should be <100, ideally <70 (if CHD, severe
stenosis, DM) • Obesity: BMI>30 increases stroke risk (duh) • Quit tobacco and secondary exposure • ETOH- the J curve
The ABCs of
Secondary Stroke
Prevention
Chris Shaffer, FNP MMP Neurology/MMC Inpatient Neurology Consult Service Maine Nurse Practitioner Association Annual Conference
stroke risk • 15% of all strokes are from Afib.
Hypertห้องสมุดไป่ตู้nsion
• Hypertension: • 72 Million Americans (2019) have HTN: >140/90 • ACEI/ARB + thiazide diuretic most protective
patients?
Womens’ Issues:
• It’s a girl thing:
• 9 Million women die each year from heart disease worldwide
• Pregnancy and cancer are pro-thrombotic states and we often overlook s/sx TIA and stroke in those populations
Monday Morning Call
• You are notified that a patient of yours is being discharged form the hospital after having an ischemic stroke.
• When should you schedule this follow-up appointment?
addition to warfarin (pharmacology update)
Antiplatelet Therapy
• Is Aspirin really enough? 81 vs 325 mg vs more? Does ASA fail?
Anticoagulation
• Indications: • Atrial Fibrillation- the elusive arrhythmia • PFO- what to do? ASA? Atrial septal aneurysm?
against stroke • What SHOULD the ideal BP be in your post-
stroke patient?
Diabetes:
• Diabetes: • 25.8 Americans have Diabetes. • What should the HbA1C be for post-stroke
• What will you address at this visit?
What Lab Tests Are Important?
• Bmp vs cmp • FLP • HbA1C
• When? Why? How often?
Clinical Resources
• AHA/ASA Get With The Guidelines • : Guidelines for the Prevention of Stroke in Patients With Stroke or Transient Ischemic Attack:
• I have no financial interest in any of the information presented today
Objectives
• Participants will understand: • 1. Indications for Antiplatelet therapy and