Władysław Lasoń

Farmakologia udaru mózgu

Pharmacology of brain stroke. Stroke is a major clinical problem and a leading cause of mortality of the contemporary world. Thrombolytic therapy with recombinant tissue plasminogen activator appears to be the most effective treatment of acute ischemic stroke, although it may be associated with haemorrhagic complication. Despite remarkable progress in biological sciences, no neuroprotective drug has been designed so far. Therefore the search for drugs aimed at improving the outcome of stroke treatment, appears justified. Besides compounds which inhibit particular steps of excitotoxic cascades e.g. glutamatergic NMDA and AMPA receptor antagonists, voltage-dependent calcium and sodium channel blockers, antioxidants and inhibitors of neuronal nitric oxide synthase some new potential neuroprotective agents have been recently proposed. To this end one should mention some protein kinase inhibitors, neuropeptides, erythropoietin, prostanoid receptor agonists, targeted neurotrophins, and some immunosuppressants. It has been widely postulated that progress in pharmacotherapy of stroke will depend on better understanding of molecular mechanism of ischemic neuronal death and survival, better animal models and more rigorously planned clinical trials with potential neuroprotective drugs.