Case scenario

You have been asked to perform a home medicines review (HMR) for Jack. Jack is an 82-year-old man who had an ischaemic stroke 3 weeks ago and is having his medicines reviewed by you as part of his HMR. He has a past medical history of hypertension and was prescribed atenolol prior to his stroke. He has no allergies nor other comorbidities. He has had a few dizzy spells recently and his blood pressure is on the low side. He tells you he has otherwise recovered well from his stroke and is currently taking:

  • Atenolol 50 mg each morning
  • Ramipril 10 mg each morning
  • Clopidogrel 75 mg each morning
  • Atorvastatin 40 mg at night.

Are these medications appropriate for Jack?

Learning objectives

After successful completion of this CPD activity, pharmacists should be able to:

  • Differentiate between primary and secondary stroke prevention
  • Summarise the pharmacological management of ischaemic strokes
  • Recognise when dual antiplatelet therapy is appropriate
  • Discuss the role of the pharmacist in ischaemic stroke prevention and management

Competencies (2016) addressed: 1.5, 2.1, 2.2, 3.3, 3.5

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Introduction

A stroke occurs every 15 minutes in Australia, equating to over 36,000 cases per year.1 It is the third leading cause of death. Mortality has declined over the past 10 years as a result of strategies to mitigate risks: specialist stroke recovery units and advances in reperfusion strategies.1 The subsequent burden of stroke to patients and carers is demanding. Potentially modifiable risk factors are estimated to cause more than 90% of strokes, these could be reduced by controlling metabolic and behavioural ri

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