At a hemorrhagic stroke the patient with the high

At a hemorrhagic stroke the patient with the high arterial pressure strained by pulse, bagrovo-cyanotic colouring of a face skin should be made an exsanguination (to take 100-200 ml of blood from an ulnar vein), on a head to put a bubble with ice, and it is even better - to impose with its bubbles with ice and to hold them within several hours, in case of need - some days with breaks on 1-2 ч; to put Sinapismuses on a back surface of buy vpxl news health a neck. To prescribe coagulums: Vicasolum, calcium gluconat. Intravenously to enter Acidum aminocapronicum (50 ml of a solution of 5 %, 3-4 times a day).
To lower arterial pressure, use Dibazolum, a papaverine; intravenously driply it is possible to enter a lytic admixture of following structure: aminazine of 2,5 % - 2 ml, Dimedrol of 1 % - 2 ml, about-medol 2 % - 1 ml, Novocainum of 0,5 % of 50 ml, a glucose of 10 % - 30 ml. In order to avoid a collapse it is necessary to supervise level of arterial pressure strictly.
At breath disorders the tracheostomy which should be used for excision of slime from respiratory tracts, and in case of need - for dispersion of solutions of antibiotics for the purpose of the prevention of a pulmonary infection in some cases is shown.
It is obligatory to prescribe preparations: Glycerinum, Lasixum (Furosemidum), Novuritum, Mannitum.
Considering, that one of the most dangerous complications of a cerebral stroke is the edema-swelling with the subsequent disposition of sites of a brain and development secondary a syndrome, it is necessary to prescribe 50 ml of Glycerinum to 100-150 ml of the cooled water or fruit juice. If the consciousness of the patient is lost, this solution can be entered into a stomach by means of a probe. Glycerinum is entered from calculation of mass of a body by of 0,2-0,5 g/kg (100-200 ml/sut). Good the effect is observed at its rectal administration.
To normalise vodno-electrolytic balance and acid-alkaline balance of the serious patients who are in an unconsciousness, it is necessary to prescribe parenteral introduction of a liquid of 1500-2500 ml a day. For this purpose it is better to use an isotonic solution of sodium of Sodium chloridum, 4 % a solution of a hydrocarbonate of sodium or 5 % a glucose solution. buy cheap levitra now online
Besides the specified preparations, for depression of arterial pressure prescribe Rausedylum, clonidine. In the absence of due effect intramusculary enter : Pentaminum (1 ml of a solution of 5 %), (1 ml of 2,5 % of a solution). For reduction of permeability of a vascular wall prescribe Ascorutinum (inside 0,1-0,2 г 3 times a day).
At an ischemic stroke first of all it is necessary to pay attention to a condition of warm activity. If it is weakened, to prescribe camphor, Cordiaminum, Korglykonum or other cardiacs. To take out or reduce expression of a vascular spastic stricture, intravenously enter 10 ml of 2,4 % of a solution of an Euphyllinum into 10 ml of 40 % of a solution of a glucose, for intake it is possible to prescribe on 0,02 г a papaverine, it is better in a combination with 0,05-0,1 г some phenobarbital and 0,3 г Theobrominum. It is useful to inhale Carbogenum (an admixture of 85 % of oxygen and 15 % of a carbon dioxide) which dilates brain and heart arteries and stimulates activity of the respiratory centre.
To struggle against a vasomotor spasm apply also Cinnarizinum (stu-geron, Cavintonum, on 1 tablet 3-4 times a day), Halidorum inside on 0,1 г 1-2 times day, Rauwolfia preparations.
At appointment of the vasodilating it is necessary to know, that in some cases they operate on the intact vessels more strongly. It can lead not to improvement, and to deterioration of blood supply of the amazed site (a steal phenomenon).
To prevent a thrombogenesis, to reduce its expression and diffusion by other vessels, it is necessary to prescribe anticoagulants indirect (Dicumarinum, a neodicoumarin, Syncumarum, veils-TANNINS, etc.) Or direct action (heparin), and also Fibrinolysinum. A neodicoumarin 2 days - on 0,15-0,1 г give inside on 0,3 г 2 times a day, and later, Phenilinum 0,03 г 3 times a day; Syncumarum 0,004 г 3-4 times in 1st day and 1-2 times in the subsequent. A heparin enter intravenously (8000-10 000 everyone 4-6). It is desirable to enter this dose driply into 500 ml of an isotonic solution of sodium of Sodium chloridum or 5 % of a solution of a glucose. Fibrinolysinum enter intravenously (driply) on 20 40 000 UNITS the Solution prepare before introduction from calculation 100-160 a preparation in 1 ml (on everyone 20000 add 10000 a heparin). The specified dose enter during 3 ч. Fibrinolysinum promotes dissolution of fibrin which accumulates in the amazed site a vessel. Similarly operate Streptokinasa.