title: Pharmacotherapy of cerebral ischemia.
abstract: BACKGROUND
  Ischemic stroke remains one of the leading causes of death and disability in the developed world. Despite many promising preclinical results, the only pharmacologic treatments proven effective in improving clinical outcome following ischemic stroke until now are administration of aspirin and acute thrombolysis using tissue-plasminogen activator.
  
  
  OBJECTIVE
  To review currently approved pharmacologic therapies as well as promising future treatment strategies for acute ischemic stroke.
  
  
  METHODS
  We performed an exhaustive PubMed search for articles published from 1950 through 2009 describing pharmacotherapy of acute ischemic stroke, focusing on agents that are currently in Phase III trials or approved for clinical use. Following this review, we present our interpretation of the existing literature and our vision of the future of pharmacotherapy for ischemic stroke.
  
  
  CONCLUSIONS
  Since the clinical success of the first intravenous thrombolytic, many studies have sought to further characterize the ideal patient population and to extend the therapeutic time window for pharmacologic thrombolysis. Additionally, despite the many failures of neuroprotective trials, several promising agents are currently undergoing Phase III investigation. With the advent of interventional techniques enabling local delivery of therapeutics into the region of the thrombus, the future of pharmacotherapy for ischemic stroke will probably include a combination of interventional techniques and pharmacotherapy.
authors.affiliation: Columbia University, Department of Neurological Surgery, 710 West 168th Street, New York, NY 10032, USA. afd12@columbia.edu
authors.forename: Andrew F
authors.initials: AF
authors.lastname: Ducruet
authors.forename: Bartosz T
authors.initials: BT
authors.lastname: Grobelny
authors.forename: Brad E
authors.initials: BE
authors.lastname: Zacharia
authors.forename: Zachary L
authors.initials: ZL
authors.lastname: Hickman
authors.forename: Mason L
authors.initials: ML
authors.lastname: Yeh
authors.forename: E Sander
authors.initials: ES
authors.lastname: Connolly
mesh_terms: D002545:Brain Ischemia / Q000188:drug therapy*; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D018696:Neuroprotective Agents / Q000627:therapeutic use; D020521:Stroke / Q000517:prevention & control; D015912:Thrombolytic Therapy
chemical_list: D005343:Fibrinolytic Agents; D018696:Neuroprotective Agents