There is a good article cited by Gruntdoc. This is about the use of Minocycline in CVA.
It is surprising so many unrelated drugs are found to have so many other uses. Some have turned out to be quiet useful. Many just a hype. The example for previous one is Chloroquine in arthritis including the recent Chikungunya epidemic. i hope this minocycline is not just one of the later. Usually what happens is after some positive effect is found, many possible explanations (which are educated guesses) are given. Obviously only a large randomized, placebo controlled study with a large sample will be the answer.
This tPA business is also of questionable use, at least in Indian settings. The patient is supposed to report to a stroke unit and tPA can be given, if we can rule-out a hemorrhage. All these within three hours (For anterior circulation strokes – the commonest). Most of the time when a patient comes after a stroke he has already crossed the gloden window period. So tPA is useless. Secondly, most of the strokes occur in the early mornings. How do we know how long the stroke process has gone? A patient wakes-up and finds out he has weakness. May be it happened just five minutes before he woke-up or maybe just after he went to sleep, 6-7 hours before. Thirdly when a CT is normal, it can mean he is having an early stroke (Conventional CT can take -12 hours for obvious changes to occur) or he is having a Transient Ischemic Attack. So what happens – you lyse a patient with TIA and take credit for natural recovery and collect the fees in between? i just feel it is not suited to India where money, resources (Trained doctors & CT) are not that freely available.
For the non-medicos visiting my site, jargon buster for the above post.
Minocycline is an antibiotic of tetracycline group.
CVA – Cerebra-vascular accident – commonly called stroke – is due to blockage of arteries most of the time by a blood clot and some times by a bleed due to a rupture of a blood vessel. Thrombolysis is the process by which the clots are removed (Thrombus- blood clot, lysis- break-down). So obviously if accidentally a patient with bleed into brain is given a thrombo-lytic drug (like tPA – Tissue Plasminogen Activator), the bleed will worsen and can sometimes be fatal.
Usually a CT scan is done as the initial investigation to evaluate whether a stroke is due to clot or bleed. It will pick-up a bleed as soon as it occurs and a clot after a few hours (Up to 12hours).
TIA – is due to a small clot in the artery, which dissolves itself and so the patient recovers completely. It is a warning of instability in that area and these patients need to go on prophylactic drugs to prevent a full blown stroke in the near future.
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