Final answer:
The correct approach for a patient who has been administered thrombolytic therapy for a thrombotic stroke is to hold aspirin for at least 24 hours post-administration of a thrombolytic agent such as tissue plasminogen activator (tPA). A CT scan must first rule out hemorrhage before tPA is given, and antiplatelet therapy such as aspirin or DAPT is commonly used as a preventive measure but not immediately following tPA administration.
Step-by-step explanation:
Guidelines for Antiplatelet and Fibrinolytic Therapy
When a 62-year-old man experiences sudden difficulty speaking and left-sided weakness, he is exhibiting signs of a stroke, which may be thrombotic. The administration of a thrombolytic agent, such as tissue plasminogen activator (tPA), is crucial if a thrombotic stroke is identified, and it should be administered within 3 hours of stroke onset to improve prognosis. Prior to this, a CT scan must confirm the absence of hemorrhage. After administering tPA, antiplatelet therapy, such as aspirin, should be withheld for at least 24 hours to reduce the risk of bleeding. The use of aspirin alone or in combination with clopidogrel (dual antiplatelet therapy, or DAPT) is usually prescribed for preventive measures in patients with arterial plaque but not an acute event. Aspirin is known to interfere with platelet function, leading to prolonged bleeding times, thus its administration must be carefully considered in the context of fibrinolytic therapy.
According to clinical guidelines, the correct approach once tPA has been administered would be to hold aspirin for at least 24 hours. If no tPA is given, aspirin could be used depending on the physician's assessment of the situation. In the absence of fibrinolytic therapy, aspirin may be given immediately to help prevent further clot formation, normally at a dose between 162 to 325 mg to be chewed for faster absorption.