Aust Prescr
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After an ischaemic stroke or transient ischaemic attack, patients have a high risk of having another stroke. Secondary stroke prevention includes antiplatelet therapy, statins and antihypertensives Aspirin, clopidogrel, or a combination of aspirin with dipyridamole are first-line options for secondary stroke prevention in the absence of atrial fibrillation Dual antiplatelet therapy has a benefit in the first three weeks after stroke, but patients should change to a single antiplatelet drug after this time Anticoagulants are indicated if the patient has atrial fibrillation. ⋯ High doses are recommended even if cholesterol concentrations are normal Antihypertensive drugs are recommended for all patients with systolic blood pressures greater than 140/90 mmHg. ACE inhibitors, calcium channel blockers and diuretics are first-line options.
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Patients with epilepsy who have been free of seizures for at least two years may be able to stop their antiepileptic drugs. Discontinuation may be considered after an individualised harm-benefit assessment and consultation with a neurologist is recommended. It is paramount to discuss with patients whether the risk of seizure recurrence is worth the benefit of stopping the antiepileptic drug. ⋯ Approximately 30-50% of patients will relapse. If seizures recur, the majority of patients regain seizure control when treatment is resumed. However up to 20% do not achieve immediate remission.