Anticoagulation; patients with cerebral embolism episode are required to be anti-coagulated primarily with heparin (7-10 days) and later on warfarin provided the predisposing heartdisease lasts. Anti-coagulation should be avoided in patients with infectious and infectious endocarditis or cardiac cancers. TIA’s patientsoftenrespond well from daily aspirin, 650 mg BD; clopidogrel, 75mg OD; or Aggrenox) (Spence & Hammond 2016). Also, TIApatients will have less attack in case they aremanaged with warfarin; nevertheless, warfarin treatmenthasanincreasedbleeding complications’ risk compared to aspirin (Aiyagari & Gorelick 2011). For reduction of risk factors, patients are giventherapy targeted at reducing the risk factors for instance management of hypertension.

Greta Balodis was discharged with Aspirin PO 100mg OD and Clopidogrel PO 75mg OD for TIA and Digoxin 125mcg PO OD to manage hypertension. However, the current medication Atenolol PO 50mg daily is for the management of hypertension and Panadol PO 500mg prn is for the management of pain.

Pharmacology

Thrombolytic, more precisely, fibrinolytic agents convert captured plasminogen to plasmin as well as binding to clot fibrin leading local fibrinolysis. Alteplase is a t-PA utilized in the management of acute MI, acute pulmonary embolism, and ischemic stroke.  However, aspirin administration prevents prostaglandin synthetase activity that later onbarssynthesis of prostaglandin and prevents the creation of platelet-aggregating thromboxane A2 (Jones & Riazi 2011). Similarly, it works on the hypothalamic heat-regulating centre to diminish fever. On the other hand, Clopidogrel preventsaggregation of platelet and is utilized for the prevention secondary CVA (Gasecki, Karaszewski, & Narkiewicz, 2016). Acetaminophen lessens high temperature by acting on hypothalamic heat-regulating centres directly byraising the body heat dissipation throughsweating and vasodilation.Atenolol, an adrenergic receptor-blocking agent produces dose-related reductions in hypertension without bringing down reflex tachycardia (Aiyagari & Gorelick 2011).

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