Cerebrovascular accident (CVA) or brain attack or
STROKE as we commonly refer to is the sudden death of
neurons in a localized area of brain due to inadequate blood
supply. The mortality rate due to stroke in India is 22 times
that of malaria and 1.4 times that of tuberculosis. It’s a major
public health challenge not only for neuropharmacology
but the society in general.1 Patients suffering from stroke
are usually recipients of a long list of medicines where the
therapy continues for a long time, usually lifelong.
Comorbidities are major determinants in the treatment
of stroke which is common in patients with hypertension,
high blood cholesterol, Diabetes Mellitus, heart disease.
Heavy smoking and alcohol consumption are other causes
for Stroke.2 According to India stroke factsheet updated in
2012, the estimated age-adjusted prevalence rate for stroke
ranges between 84/100,000 and 262/100,000 in rural and
between 334/100,000 and 424/100,000 in urban areas.3 Recent
reports have shown a substantial increase of stroke in
younger population.4 50% of stroke is preventable by control
of modifiable risk factors and lifestyle changes (aerobic
exercise to counteract inactivity, weight loss in obesity,
glucose control in diabetics, smoking cessation, and
diet).5American Stroke Association (ASA) and the American
Heart Association (AHA) have recently published updated
guidelines for secondary prevention of stroke.6,7
The management of stroke should be individualized. As
proper drug utilization is a concern for various diseases, the
same is also important for stroke management. The drug
utilization in stroke care is of very much concern in developing
countries, as healthcare infrastructure is inadequate,
government has insufficient control on the system of drug
supply and also due to free availability of drugs on prescription
often illegally. The drug treatment strategy is involved
with proper selection of drugs like thrombolytics, anticoagulants,
antihypertensives (angiotensin converting enzyme inhibitors,
angiotensin II receptor blockers, diuretics), blood
lipid lowering agents (statins), antiplatelet drugs (aspirin
and clopidogrel), and neuro protectors.8
A patient’s psychological functioning and psycho-social
situation may be severely disrupted by the disease. The degree
of disturbance is usually determined by the severity of
the stroke and degree of cognitive deficits. Hence, studying
QOL in patients is also one of the aims of the study.9
Post-stroke cognitive impairment is very common, particularly
after recurrent stroke, which affects up to one-third
of stroke survivors.10,11 These comorbid motor and cognitive
impairments can significantly increase the risk of long
term functional disability as well as increase the healthcare
costs.12 Most of the patients recover in first 3-6 months after
the acute neurological event, with almost 70% of their
recovery in first 3 months after a stroke. After 6 months, the
recovery can be considered to be almost nil. However, for the
hemiplegics, physiotherapy can be a healthy source for gaining
the stairway to becoming physically fit.13 Thus, along
with medications functional recovery also depends upon institution
of early rehabilitation, which aims to enhance skill
learning which promotes plasticity
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