Ischemic stroke causes brain damage by multiple pathways. Previous stroke trials have demonstrated that drugs targeting one or only a few of these pathways fail to improve clinical outcome after stroke. Drugs with multimodal actions have been suggested to overcome this challenge. In this review, we describe the mechanisms of action of agents approved for secondary prevention of ischemic stroke, such as antiplatelet, antihypertensive, and lipid-lowering drugs. These drugs exhibit considerable properties beyond their classical mechanisms, including neuroprotective and neuroregenerative properties. In addition, candidate stroke drugs currently studied in clinical phase III trials are described. Among these, albumin, hematopoietic growth factors, and citicoline have been identified as promising agents with multiple mechanisms. These drugs offer hope that additional treatment options for the acute phase after a stroke will become available in the near future.

中文翻译：

---

已批准和候选中风药物的多功能作用。


缺血性中风通过多种途径导致脑损伤。先前的中风试验表明，针对其中一种或仅少数几种途径的药物无法改善中风后的临床结果。已建议使用具有多模式作用的药物来克服这一挑战。在这篇综述中，我们描述了批准用于缺血性中风二级预防的药物的作用机制，例如抗血小板药物、抗高血压药物和降脂药物。这些药物表现出超出其经典机制的相当多的特性，包括神经保护和神经再生特性。此外，还描述了目前正在临床III期试验中研究的候选中风药物。其中，白蛋白、造血生长因子和胞二磷胆碱已被确定为具有多种机制的有前途的药物。这些药物为中风后急性期的其他治疗选择在不久的将来提供了希望。