What do you give to a patient not receiving tPA within 48 hours after an ischemic stroke?

Aspirin is the appropriate choice for a patient who is not receiving tPA (tissue plasminogen activator) within 48 hours after an ischemic stroke. Administering aspirin in this timeframe is supported by evidence demonstrating its role in reducing the risk of subsequent stroke and cardiovascular events.

In patients with acute ischemic stroke, aspirin can be initiated after the acute phase has passed, particularly if they have not received thrombolysis. It is often recommended to start aspirin within 24 to 48 hours after the stroke onset, as it helps to prevent further thromboembolic events.

The alternative medications listed have different indications and timing considerations. Ibuprofen is generally avoided in the acute phase of stroke management due to potential risks of bleeding. Clopidogrel is not recommended as the first-line therapy within this specific time frame and is typically considered for more prolonged management, especially in patients with recurrent stroke risk or in conjunction with aspirin in certain scenarios. Warfarin is an anticoagulant that is used primarily for patients with atrial fibrillation or other specific indications and is not indicated immediately after an ischemic stroke unless there are underlying conditions that necessitate it.

Using aspirin in this context benefits the patient by reducing the likelihood of