Home' Australian Pharmacist : March 2011 Contents Vol. 30 -- March #03
Continuing Professional Development
The articles in this series are independently researched and compiled by PSA commissioned authors and peer reviewed.
Mr Jones, an active 70-year-old,
comes into the pharmacy with
his wife. He was discharged from
hospital two days ago after being
diagnosed with a transient ischaemic
attack (TIA). He presents with new
prescriptions including the aspirin
25 mg/dipyridamole 200 mg SR
combination preparation. He is
complaining of a persistent headache
since returning home, which he
believes may be due to one of his
• The risk of a stroke following a TIA
can be estimated based on patient
characteristics and risk factors. Up
to 12% of patients classified as
high-risk may experience a stroke
within seven days after a TIA.6
Given the potential risks, continued
adherence with the newly initiated
medicines should be emphasised
to Mr Jones. Headache is common
on initiation of treatment with the
The incidence of headache may
be minimised by advising patients
to begin by only taking the aspirin
25 mg/dipyridamole 200 mg SR
capsule at night WITH aspirin
100 mg in the morning for seven
days. After the initial seven days
the dose of the combination
capsule should be increased to
twice daily with cessation of aspirin
100 mg.39 If headache continues
to be troublesome, an alternative
antiplatelet should be considered.
• It is important to provide adequate
counselling to both Mr and Mrs
Jones on the signs and symptoms
of a TIA or stroke, and the use of
the FAST test should be explained.
Contacting 000 for immediate
assistance should be emphasised
given the limited time window for
administration of thrombolysis.
• Mr Jones should be advised to
consult his medical practitioner
or neurologist before resuming
driving. It is generally advised
that patients do not drive
for at least one month after
experiencing a TIA or stroke,
although recommendations may
vary according to degree of
functional impairment.40 Additional
information may be obtained
from state licensing authorities
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evidence in patient care
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