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In deciding whether to use a clot buster, its potential benefits must be weighed against its risks. In most cases, people with the following conditions should avoid the use of clot-busting drugs:
- Hemorrhagic stroke (excessive bleeding into or around the brain)
- Aortic dissection (tear in lining of aorta)
- Other stroke or cerebrovascular event in the past year
- Severe or chronic high blood pressure (hypertension)
- Previous allergic reaction to a clot buster, other allergies
- Active ulcer
- Pregnancy or recent childbirth
- Blood disease
- Bleeding disorder, or recent history of bleeding in any part of the body
- Severe liver disease
- Recent surgery
- Recent falls or blows to the head
- Recent cardiopulmonary resuscitation (CPR)
- Brain disease or tumor
- Heart disease (including arrhythmia)
- Recent strep (streptococcal) infection
- Recent injection, catheterization or surgery
In addition, research has suggested that heart attack patients with diabetes may not get the same benefit from the use of clot-busting drugs as people with normal blood sugar control. While the reason for this is not fully understood, physicians may choose alternate therapies for diabetic patients. Among stroke patients, a study is underway to determine if lowering blood sugar levels before administration of clot-busting drugs will improve outcomes.
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