As hyperthermia may exacerbate neurological injury, acetaminophen may be given to reduce fever and to relieve headache. Antidotes reverses some coagulopathies or bleeding diatheses. Phytonadione; Vitamin K (Promotes hepatic synthesis of clotting factors that inhibit warfarin effects) and protamine (salt with heparin and neutralizes its effects) are used to restore normal coagulation parameters.
Questions regarding the optimal medical and surgical management of ICH still remain, recent clinical trials examining hemostatic therapy, blood pressure control, and hematoma evacuation have advanced the understanding of ICH management. Timely and aggressive management in the acute phase may mitigate secondary brain injury. Drug development pipelines have drug candidate in the phase I,II, III of development to treat ICH.
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VKA-Related ICH Fresh frozen plasma (FFP), along with vitamin K, has been the mainstay of treatment in the United States for years, but more recently, prothrombin complex concentrates (PCCs), the activated PCC FEIBA (factor VIII inhibitor bypassing activity), and recombinant activated factor VIIa (rFVIIa) are potential therapies. Administration of intravenous vitamin K alone is insufficient for reversal in the first hours but should be part of all acute VKA reversal strategies in a dose of 5 to 10 mg, usually given slowly via the intravenous route.
The current emerging landscape for Intracranial Hemorrhage mainly comprising of Phase I, Phase II and Phase III candidate drugs. The key players are Idorsia Pharmaceuticals , AegisCN, GlaxoSmithKline, Yantai YenePharma, and others.
Antacids are used to prevent gastric ulcers associated with intracerebral hemorrhage. Famotidine minimizes development of gastric ulcers, competitively inhibits histamine at H2 receptor of gastric parietal cells, resulting in reduced gastric acid secretion, gastric volume, and hydrogen concentration. Glucose should be monitored. Both hyperglycemia and hypoglycemia should be avoided, Clinical seizures should be treated with antiseizure drugs.
Read More @ Intracranial hemorrhage Pipeline Report
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