Access restricted to higher education institution's students and staff
master's thesis
SEKUNDARNA PREVENCIJA MOŽDANOG UDARA

Mirna Knežević (2015)
Metadata
TitleSEKUNDARNA PREVENCIJA MOŽDANOG UDARA
AuthorMirna Knežević
Mentor(s)Lidija Tuškan-Mohar (thesis advisor)
Abstract
Moždani udar jedan je od glavnih uzroka smrti i invaliditeta u svijetu koji sa sobom nosi brojne posljedice. Iako je došlo do napretka u dijagnostici i liječenju, danas je glavni pristup kod njega prevencija. Sekundarna prevencija primjenjuje se kod osoba koje su preboljele MU ili TIA-u s ciljem sprječavanja ponovnog recidiva. Među najznačajnije čimbenike rizika ubrajaju se hipertenzija, dislipidemija, fibrilacija atrija, karotidna stenoza i dijabetes. Prvi korak u prevenciji je promjena nezdravog načina života. To uključuje prestanak pušenja, promjenu prehrane i redukciju tjelesne težine te povećanje tjelesne aktivnosti. Ukoliko osoba ima prateću bolest koja je povezana s razvojem MU, uvodi se ciljanja terapija. Tako se kod liječenja hipertenzije prednost daje diureticima i kombinaciji diuretika sa ACE inhibitorima dok se liječenje dislipidemije provodi uvođenjem statina. Kod stenoze karotidne arterije optimalno liječenje postiže se primjenom antiagregacijske terapije, uvođenjem statina i strogom redukcijom čimbenika rizika. Ukoliko je prisutna značajna stenoza karotidne arterije, indicirana je karotidna TEA ili se provodi endovaskularni zahvat. Aspirin, klopidogrel, dipiridamol i tiklopidin spadaju u skupinu antiagregacijskih lijekova, svojim djelovanjem smanjuju učestalost vaskularnih incidenata i samog MU-a. Peroralna antikoagulantna terapija veoma je učinkovita u prevenciji kardioembolijskog MU-a koji je najčešće uzrokovan fibrilacijom atrija. Najbolji terapeutski učinak postiže se varfarinom. Ipak zbog njegove uske terapijske širine i nuspojava proizvedeni su novi oralni antikoagulansi.
Keywordsstroke secondary prevention risk factors
GranterSveučilište u Rijeci
Medicinski fakultet
Lower level organizational unitsKatedra za neurologiju
PlaceRijeka
StateCroatia
Scientific field, discipline, subdisciplineBIOMEDICINE AND HEALTHCARE
Clinical Medical Sciences
Neurology
Study programme typeuniversity
Study levelintegrated undergraduate and graduate
Study programmeMedicine
Academic title abbreviationdr. med.
Genremaster's thesis
Language Croatian
Defense date2015
Parallel abstract (English)
A stroke is one of the major death and disability causes in the world and has many consequences. Even though there has been a lot of progress in diagnostics and treatment, the main approach today is prevention. Secondary prevention can be used in people who have already had a stroke or TIA in order to prevent its relapse. The most important risk factors are hypertension, dyslipidemia, atrial fibrillation, carotid stenosis and diabetes. The first prevention step is to change the way of life which includes diet changes, reduction of body weight, increasing physical activity and quitting smoking. A more targeted therapy is used in people who have an accompanying disease. Therefore, diuretics and combination of diuretics and ACE inhibitors are used in treating hypertension, while dyslipidemia is treated with statins. An optimal treatment in carotid artery stenosis includes antiplatelet therapy, statins and a strict reduction of risk factors. Placing a stent or a carotid thrombendarterectomy is indicated if there is a significant level of carotid artery stenosis. Aspirin, clopidogrel, dipyridamole and ticlopidine, as representatives of platelet antiaggregation group of medications, decrease the frequency of vascular incidents and the stroke itself. Peroral anticoagulant therapy is proven to be very effective in preventing a cardioembolic stroke which is primarily caused with atrial fibrillation. In those cases, the best therapeutical effect is achieved with warfarin. However, due to its narrow therapeutic range and its side effects new oral anticoagulant drugs have been manufactured.
Parallel keywords (Croatian)moždani udar sekundarna prevencija čimbenici rizika
Resource typetext
Access conditionAccess restricted to higher education institution's students and staff
Terms of usehttp://rightsstatements.org/vocab/InC/1.0/
URN:NBNhttps://urn.nsk.hr/urn:nbn:hr:184:918562
CommitterBosa Licul