Pharmacotherapy of cerebral ischemia

Document Type

Article

Abstract

BACKGROUND: Ischemic stroke remains one of the leading causes of death and disability in the developed world. Despite many promising preclinical results, the only pharmacologic treatments proven effective in improving clinical outcome following ischemic stroke until now are administration of aspirin and acute thrombolysis using tissue-plasminogen activator. OBJECTIVE: To review currently approved pharmacologic therapies as well as promising future treatment strategies for acute ischemic stroke. METHODS: We performed an exhaustive PubMed search for articles published from 1950 through 2009 describing pharmacotherapy of acute ischemic stroke, focusing on agents that are currently in Phase III trials or approved for clinical use. Following this review, we present our interpretation of the existing literature and our vision of the future of pharmacotherapy for ischemic stroke. RESULTS/CONCLUSIONS: Since the clinical success of the first intravenous thrombolytic, many studies have sought to further characterize the ideal patient population and to extend the therapeutic time window for pharmacologic thrombolysis. Additionally, despite the many failures of neuroprotective trials, several promising agents are currently undergoing Phase III investigation. With the advent of interventional techniques enabling local delivery of therapeutics into the region of the thrombus, the future of pharmacotherapy for ischemic stroke will probably include a combination of interventional techniques and pharmacotherapy.

Medical Subject Headings

Brain Ischemia (drug therapy); Fibrinolytic Agents (therapeutic use); Humans; Neuroprotective Agents (therapeutic use); Stroke (prevention & control); Thrombolytic Therapy

Publication Date

8-1-2009

Publication Title

Expert opinion on pharmacotherapy

E-ISSN

1744-7666

Volume

10

Issue

12

First Page

1895

Last Page

906

PubMed ID

19514865

Digital Object Identifier (DOI)

10.1517/14656560903055095

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