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4. Rehabilitation

4.4 Drugs associated with rehabilitation and secondary prevention of stroke

Please see the NICE pathway on stroke and the NICE clinical & technology guidelines, which link to treatments for secondary prevention e.g.
Anticoagulation
Antiplatelets
Lipid Lowering Therapy
Anti Hypertensives
Atrial Fibrillation (See NICE guidelines on newer anticoagulants: dabigatran and rivarixaban
Diabetes
www.nice.org.uk

Dysphagia and medication administration:

45-50% of acute stroke patients are dysphagic and pose a choking risk when taking tablets or capsules. There may be an increased risk of a tablet or capsule becoming lodged in the patient’s throat or oesophagus, resulting in incorrect drug dispersal and subsequent changes in efficacy and/or tolerability, and possible oesophageal damage.

It is vital that dysphagic patients are regularly assessed by the community rehabilitation team.

Dysphagic patients will require formulation alterations which have important medical and legal implications. Special-order (‘special’) liquid medicines are unlicensed and expensive. They should only be used if there is no licensed medicine that meets the patient’s needs.

More information can be obtained from SIGN (Sign- management of patients with stroke: identification and management of dysphagia (June 2010) http://www.sign.ac.uk/guidelines/fulltext/119/index.html)