tPA for Stroke : The Story of a Controversial Drug

[Neuroresident]

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http://www.amazon.com/tPA-Stroke-St...OLBBL2/ref=kinw_dp_ke?ie=UTF8&m=AG56TWVU5XWC2

Has anybody read this book? Just wanted to know if it is a good read. Thanx!

 

[neurologist]

Haven't heard of it, but now that I have, I think I'll check it out.

Here's a link to what I suspect (from reading the Amazon page) is a similar journal article that I recalled reading quite a while ago on this topic:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1122648/?tool=pubmed

 

[RAD345]

Interesting topic! Thank you for bringing this up after all these topics of "neurology or psychology" and INR pathways" and etc.

it is always both sides for a story and there are some pros and cons for every medicine, even multi-vitamins. I think tPA is now the only medicine that we have for stroke and there are new data coming out that it might help restore neurons in mice intra-nasally even 10-14 days after stroke. That is super interesting.

http://www.ncbi.nlm.nih.gov/pubmed/22115941

also there is some data that it might be toxic and cause neuron death.\

http://www.ncbi.nlm.nih.gov/pubmed/21998719


There are newer thrombolytics under way, like Tenectaplase that they use for Acute MI but we have given that for stroke and it has worked. Actually the phase 2 of study on Tenectalplace (TNK) was held because of poor recruitment.

http://www.ncbi.nlm.nih.gov/pubmed/21737464

http://www.ncbi.nlm.nih.gov/pubmed/22111795


I think at this time, it works well for our purpose when we do not have anything else to offer (for someone that do not have access to mechanical thrombctomy or does have small vessles thrombus that won't worth going after it) it gives me a self-satisfaction that at least I do something for patients, especially when they arrive in the first hour after stroke. I believe, it really works if it is given early (less than 2 hours) and studies support that.

http://stroke.ahajournals.org/content/40/6/2268.full.pdf

 

[RAD345]

A Randomized Trial of Tenecteplase versus Alteplase for Acute Ischemic Stroke, NEJM, Mar. 22th, 2012:

http://www.nejm.org/doi/full/10.1056/NEJMoa1109842

Tenecteplase was associated with significantly better reperfusion and clinical outcomes than alteplase in patients with stroke who were selected on the basis of CT perfusion imaging

 

[danielmd06]

http://www.amazon.com/tPA-Stroke-St...OLBBL2/ref=kinw_dp_ke?ie=UTF8&m=AG56TWVU5XWC2

Has anybody read this book? Just wanted to know if it is a good read. Thanx!

Funny when you read the quotes about the book through your link. Lazy neurologists and frightened emergency medicine people? Sounds like a fun read, though.

I myself prefer military history and paleontology.