Stroke Pharmacotherapy for NAPLEX: Ischemic, Hemorrhagic, TIA & Prevention

Master stroke pharmacotherapy for the NAPLEX with this high-yield Pharmaste review covering ischemic stroke, hemorrhagic stroke, TIA, acute treatment, secondary prevention, and patient-safety updates. In this video, we break down the most important stroke concepts pharmacy students and graduates need to know for board exams and clinical practice. You’ll learn how to quickly separate ischemic stroke from hemorrhagic stroke, why imaging comes before thrombolysis, how to recognize key safety traps, and how to choose the right pharmacotherapy based on the patient scenario. We cover acute ischemic stroke treatment, including alteplase, tenecteplase, thrombectomy, blood pressure thresholds, aspirin timing, glucose goals, and DVT prophylaxis. Special focus is placed on the newer tenecteplase dosing update: stroke dose 0.25 mg/kg max 25 mg, not the STEMI dose and not the older 0.4 mg/kg dose. We also review secondary prevention after ischemic stroke or TIA, including aspirin, clopidogrel, aspirin/extended-release dipyridamole, short-course dual antiplatelet therapy, statins, hypertension control, atrial fibrillation, and key drug interactions such as clopidogrel with omeprazole or esomeprazole. For hemorrhagic stroke, we cover intracerebral hemorrhage management, anticoagulation reversal, blood pressure targets, mannitol, intracranial pressure management, and subarachnoid hemorrhage treatment with nimodipine — including the boxed warning that nimodipine must never be given IV. This lesson is designed for NAPLEX candidates, pharmacy students, pharmacy residents, medical trainees, and clinicians who want a clear, practical, exam-focused stroke pharmacotherapy review. Key topics covered: Stroke types: ischemic vs hemorrhagic TIA and secondary stroke prevention BE-FAST and acute stroke workflow Non-contrast CT before thrombolysis Alteplase dosing and monitoring Tenecteplase dosing for acute ischemic stroke Tenecteplase stroke vs STEMI dosing safety trap Blood pressure management in acute stroke Aspirin timing after thrombolysis Endovascular thrombectomy Dual antiplatelet therapy after minor stroke or high-risk TIA Clopidogrel and CYP2C19 drug interactions Prasugrel contraindication in stroke/TIA Intracerebral hemorrhage management Warfarin, dabigatran, and factor Xa inhibitor reversal Subarachnoid hemorrhage and nimodipine Mannitol and intracranial pressure High-yield NAPLEX patient-safety pearls Educational use only. Always follow current guidelines, FDA labeling, institutional protocols, and patient-specific clinical judgment. #NAPLEX #Stroke #Pharmacotherapy #PharmacySchool #PharmD #PharmacyEducation #Tenecteplase #Alteplase #HemorrhagicStroke #IschemicStroke #TIA #MedicationSafety