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Tenecteplase for Acute Ischemic Stroke Treatment
Semin Neurol DOI: 10.1055/s-0040-1722722The introduction of thrombolytic therapy in the 1990s has transformed acute ischemic stroke treatment. Thus far, intravenous recombinant tissue plasminogen activator (rt-PA) also known as alteplase is the only thrombolytic proven to be efficacious and approved by the United States Food and Drug Administration. But the thrombolytic agent tenecteplase (TNK) is emerging as a potential replacement for rt-PA. TNK has greater fibrin specificity, slower clearance, and higher resistance to plasminogen activator inhibitor-1 than rt-PA. Hence, TNK has the potential to provide superior lysis wi...
Source: Seminars in Neurology - January 20, 2021 Category: Neurology Authors: Baird, Alison E. Jackson, Richard Jin, Weijun Tags: Review Article Source Type: research

Janssen Submits Application to U.S. FDA for New Indication to Expand Use of XARELTO ® (rivaroxaban) in Patients with Peripheral Artery Disease
RARITAN, NJ, October 26, 2020 – The Janssen Pharmaceutical Companies of Johnson & Johnson announced today it has submitted a supplemental New Drug Application (sNDA) to the U.S. Food and Drug Administration (FDA) for a new indication to expand the use of XARELTO® (rivaroxaban) in patients with peripheral artery disease (PAD). If approved, this new indication for the XARELTO® vascular dose (2.5 mg twice daily plus aspirin 75-100 mg once daily) would include reducing the risk of major thrombotic vascular events such as heart attack, stroke and amputation in patients after recent lower-extremity revascularization, a c...
Source: Johnson and Johnson - October 26, 2020 Category: Pharmaceuticals Tags: Innovation Source Type: news

Monoclonal antibody as an emerging therapy for acute ischemic stroke.
Authors: Woods D, Jiang Q, Chu XP Abstract Acute ischemic stroke (AIS) is the 5th leading cause of death and the leading cause of neurological disability in the United States. The oxygen and glucose deprivation associated with AIS not only leads to neuronal cell death, but also increases the inflammatory response, therefore decreasing the functional outcome of the brain. The only pharmacological intervention approved by the US Federal Food and Drug Administration for treatment of AIS is tissue plasminogen activator (t-PA), however, such treatment can only be given within 4.5 hours of the onset of stroke-like sympto...
Source: International Journal of Physiology, Pathophysiology and Pharmacology - September 18, 2020 Category: Physiology Tags: Int J Physiol Pathophysiol Pharmacol Source Type: research

Researcher Studies Statins for Stroke Therapy
Stacy Pigott A $2.8 million grant may help develop an improved therapeutic treatment for acute ischemic stroke patients to let them recover faster with fewer long-term complications. The protocol hinges on effectively delivering statins to the brain, where their neuroprotective properties can help save tissue damaged by stroke. Aug. 7, 2020 University of Arizona Health Sciencesnhg-PATRICK-RONALDSON_DSC6492-web.jpg Patrick Ronaldson (right), associate professor in the College of Medicine – Tucson's Department of Pharmacology, and doctoral students Erica Williams and Robert Betterton discuss their latest researc...
Source: The University of Arizona: Health - August 6, 2020 Category: Universities & Medical Training Authors: mittank Source Type: research

Acute ischemic stroke: improving access to intravenous tissue plasminogen activator.
This article gives an overview of the recent approaches pursued to improve access to alteplase for acute ischemic stroke patients. Utilization of stroke systems of care, quality metrics, and quality improvement initiatives to improve alteplase treatment rates are discussed. The implementation of Telestroke networks to improve access and timely evaluation by a stroke specialist are also reviewed. Lastly, this review discusses the use of neuroimaging techniques to identify alteplase candidates in stroke of unknown symptom onset or beyond the 4.5-hour treatment window.Expert commentary: Expanding access to alteplase therapy f...
Source: Expert Review of Cardiovascular Therapy - April 25, 2020 Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research

Using Tenecteplase for Acute Ischemic Stroke: What Is the Hold Up?
Alteplase is the only Food and Drug Administration-approved intravenous (IV) thrombolytic medication for acute ischemic stroke. However, multiple recent studies comparing tenecteplase and alteplase suggest that tenecteplase is at least as efficacious as alteplase with regards to neurologic improvement. When given at 0.25 milligrams per kilogram (mg/kg), tenecteplase may have less bleeding complications than alteplase as well. This narrative review evaluates the literature and addresses the practical issues with regards to the use of tenecteplase versus alteplase for acute ischemic stroke, and it recommends that physicians ...
Source: Western Journal of Emergency Medicine - February 24, 2020 Category: Emergency Medicine Source Type: research

Medication Adherence and Stroke Prevention: What Real World Data Tells Us.
Authors: Hsieh CY Abstract Medication adherence, by definition,(2) is "the extent to which a patient acts in accordance with the prescribed interval and dose of a dosing regimen." Poor medication adherence can interfere with the ability to treat many diseases, leading to greater complications and a lower quality of life.(3) In this issue of Acta Neurologica Taiwanica, Chen et al.(4) presented the inverse association between adherence of antithrombotic agents and poor outcomes after a first-ever ischemic stroke. The findings were consistent with Sung, et al.(5) that medication nonadherence are prevalent in young adu...
Source: Acta Neurologica Taiwanica - February 7, 2020 Category: Neurology Tags: Acta Neurol Taiwan Source Type: research

ICU Nursing Care of the Stroke Patient
Almost 25 years ago, in June 1996, the Food and Drug Administration (FDA) approved intravenous (IV) Alteplase as the only acute drug therapy for ischemic stroke. It remains the mainstay drug to date and revolutionized Neurology, Stroke, and Neurocritcal Care. In 2013, the success of several mechanical thrombectomy studies proved the efficacy of endovascular thrombectomy for large vessel occlusions (LVO), both alone and in combination with IV Alteplase. The expanded time window opened this treatment option to a greater number of patients, who are now surviving with fewer deficits.
Source: Critical Care Nursing Clinics of North America - February 1, 2020 Category: Nursing Authors: Mary P. Amatangelo Tags: Preface Source Type: research

The Role of Informed Consent for Thrombolysis in Acute Ischemic Stroke.
Authors: Comer AR, Damush TM, Torke AM, Williams LS Abstract Although tissue plasminogen activator (tPA) is the only medication approved by the United States Food and Drug Administration (FDA) for acute ischemic stroke, there is no consensus about the need for informed consent for its use. As a result, hospitals throughout the U.S. have varying requirements regarding obtaining informed consent from patients for the use of tPA, ranging from no requirement for informed consent to a requirement for verbal or written informed consent. We conducted a study to (1) determine current beliefs about obtaining patients' infor...
Source: Journal of Clinical Ethics - December 20, 2019 Category: Medical Ethics Tags: J Clin Ethics Source Type: research

Arsenic exposure: A public health problem leading to several cancers
Publication date: Available online 23 November 2019Source: Regulatory Toxicology and PharmacologyAuthor(s): I. Palma-Lara, M. Martínez-Castillo, J.C. Quintana-Pérez, M.G. Arellano-Mendoza, F. Tamay-Cach, O.L. Valenzuela-Limón, E.A. García-Montalvo, A. Hernández-ZavalaAbstractArsenic, a metalloid and naturally occurring element, is one of the most abundant elements in the earth's crust. Water is contaminated by arsenic through natural sources (underground water, minerals and geothermal processes) and anthropogenic sources such as mining, industrial processes, and the production and use of pesticides. Humans are exposed...
Source: Regulatory Toxicology and Pharmacology - November 23, 2019 Category: Toxicology Source Type: research

Arsenic exposure: A public health problem leading to several cancers.
Abstract Arsenic, a metalloid and naturally occurring element, is one of the most abundant elements in the earth's crust. Water is contaminated by arsenic through natural sources (underground water, minerals and geothermal processes) and anthropogenic sources such as mining, industrial processes, and the production and use of pesticides. Humans are exposed to arsenic mainly by drinking contaminated water, and secondarily through inhalation and skin contact. Arsenic exposure is associated with the development of vascular disease, including stroke, ischemic heart disease and peripheral vascular disease. Also, arseni...
Source: Regulatory Toxicology and Pharmacology : RTP - November 21, 2019 Category: Toxicology Authors: Palma-Lara I, Martínez-Castillo M, Quintana-Pérez JC, Arellano-Mendoza MG, Tamay-Cach F, Valenzuela-Limón OL, García-Montalvo EA, Hernández-Zavala A Tags: Regul Toxicol Pharmacol Source Type: research

The Transformation of Our Specialty and Our Relationship with Stroke Care —Adapting to a Changing Landscape
Since the first case series of vertebrobasilar intra-arterial thrombolysis was reported by Zeumer et  al in 1983 (1), catheter-directed management of ischemic stroke has evolved into an effective therapy substantiated by a strong body of evidence—and healthy patients. Initially, catheter-directed thrombectomy, stimulated by the 2004 US Food and Drug Administration approval of the MERCI retriever , was highly controversial. Nevertheless, the performance of intracranial thrombectomy became widespread in the 2000s as a result of pervasive anecdotal evidence of efficacy and a payment structure that incentivized hospitals to...
Source: Journal of Vascular and Interventional Radiology : JVIR - September 1, 2019 Category: Radiology Authors: Laura K. Findeiss Tags: Commentary Source Type: research

Vagus nerve stimulation as a promising adjunctive treatment for ischemic stroke
Publication date: Available online 21 August 2019Source: Neurochemistry InternationalAuthor(s): Jingxi Ma, Peifeng Qiao, Qin Li, Yangyang Wang, Lan Zhang, Liang-Jun Yan, Zhiyou CaiAbstractThe Food and Drug Administration has approved vagus-nerve stimulation (VNS) for the treatment of patients with epilepsy, depression, and headache. By targeting diverse neuroprotective and neuroplasticity pathways, VNS has the potential to be expanded as a treatment for ischemic stroke. VNS has been found to attenuate infarct volume, reduce neurological deficits, and improve memory and cognition in rats with stroke injuries. Some pilot stu...
Source: Neurochemistry International - August 22, 2019 Category: Neuroscience Source Type: research

Choosing the Correct “-ase” in Acute Ischemic Stroke: Alteplase, Tenecteplase, and Reteplase
Alteplase is a tissue plasminogen activator approved for treating acute ischemic stroke (AIS), acute myocardial infarction (AMI), and acute massive pulmonary embolism. Two additional tissue plasminogen activators, tenecteplase and reteplase, are also approved for AMI treatment. However, neither tenecteplase nor reteplase is approved for AIS treatment. The U.S. Food and Drug Administration has received reports of accidental administration of tenecteplase or reteplase instead of alteplase in patients with AIS, which can lead to potential overdose. Primary factors contributing to medication errors include use of the abbreviat...
Source: Advanced Emergency Nursing Journal - July 1, 2019 Category: Emergency Medicine Tags: PROCEDURAL COLUMN Source Type: research

Molecules, Vol. 24, Pages 2323: Advances in Biosynthesis, Pharmacology, and Pharmacokinetics of Pinocembrin, a Promising Natural Small-Molecule Drug
ng Yang Pinocembrin is one of the most abundant flavonoids in propolis, and it may also be widely found in a variety of plants. In addition to natural extraction, pinocembrin can be obtained by biosynthesis. Biosynthesis efficiency can be improved by a metabolic engineering strategy and a two-phase pH fermentation strategy. Pinocembrin poses an interest for its remarkable pharmacological activities, such as neuroprotection, anti-oxidation, and anti-inflammation. Studies have shown that pinocembrin works excellently in treating ischemic stroke. Pinocembrin can reduce nerve damage in the ischemic area and reduce mitochon...
Source: Molecules - June 23, 2019 Category: Chemistry Authors: Xiaoling Shen Yeju Liu Xiaoya Luo Zhihong Yang Tags: Review Source Type: research

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