[RNPQT]

My mother has had a couple of small strokes over the past several years, was on coumadin for a while, then switched to enteric-coated ASA.

She was recently hospitalized for another stroke which affected just her facial nerve. Bells Palsy was ruled-out, and they said it was due to small vessel disease. The Neurologist that rounded on her said she should take regular ASA, not enteric-coated. Her primary consulted another Neurologist for a second opinion, thinking she should take Plavix. The 2nd Neurologist said she should take Aggrenox instead of ASA or Plavix. THEN an RN chimed in and said she should take Aggrenox with 151 mg of ASA daily, because Aggrenox does not have enough aspirin in it. He could not show me the research on it, and I'm just wondering if anyone has knowledge of this or can point me in the right direction of a current study?

[NRSKarenRN]

Queensland Clinical Clerk/Med Student TX Decision: Approach to the Weak and Dizzy Patient

Stroke: Prevention and Acute Management


Secondary Prevention of Ischemic Stroke with Antiplatelet Agents

When compared with placebo, stroke risk was
reduced by 18% with ASA 25 mg bid, 16% with ER
dipyridamole 200 mg bid and 37% with combination
therapy. After two years of follow-up, stroke rates were
12.5% with ASA alone, 12.7% with dipyridamole alone,
9.5% with combination therapy and 15.1% with placebo.
The results confirmed that the combination of ASA and
ER dipyridamole was significantly more effective than
either component prescribed alone for prevention of
stroke. The stroke reduction from ASA alone also
confirmed the efficacy of low dose ASA

Is acetylsalicylic acid plus dipyridamole superior to ASA alone ...

A Peer-Reviewed Bulletin for the Family Physician

Newer antiplatelet agents are also available and useful. In
one study, clopidogrel (Plavix) caused a relative risk reduction
of 8.7 percent for the combined endpoint of stroke, MI or
vascular death, compared with aspirin.38 Another study
found 24 percent reduction of secondary strokes for those
who took a combination of dipyridamole and ASA (ER-DP/
ASA) (Aggrenox).39 Dipyridamole (Persantine) alone has not
been found to be useful for stroke prevention. The American
College of Chest Physicians (ACCP) guidelines state that ASA,
clopidogrel and ER-DP/ASA are all acceptable as first-line
agents for secondary stroke prevention.40 Patients who receive
these agents while hospitalized have the best outcomes and best
adherence to their treatment schedules, as assessed at follow-up
visits with their physicians.

Aetna Pharmacy Policy decision on Antiplatelet Med Coverage---covers med:
http://www.aetna.com/products/rxmedi...elet_2007.html

Stroke Prevention Clinical Trials:Stroke Trials Registry