6. Neuroanesthesia Flashcards
drugs that lower ICP
mannitol
hypertonic saline
furosemide
corticosteroids
mannitol mech
hyperosmotic
pulls fluid from brain
mannitol DOA
6 hrs
after mannitol dose, when should ICP start decreasing?
within 30 mins
mannitol max effect?
1-2 hrs
mannitol tachyphylaxis
24-48 hrs
mannitol SE
hyperosmolarity
hyponatremia
hypokalemai
mannitol dose
0.25-0.5 g/kg IV
mannitol goal serum osm
300-315 mOsm/L
what serum osm should you stop mannitol?
320 mOsm/L
what can happen with a larger initial dose of mannitol?
rebound incr in ICP
mannitol monitoring
serum osmolarity
urine output
BP
electrolytes
mannitol pts require a _______
intact BBB
mannitol CI
TBI
HF
anuerysms
AV malformation
brain bleed
hypertonic saline MOA
hyperosmotic
pulls fluid from brain
hypertonic saline SE
serum hypernatremia
hypernatremia is associated with
serum Na > 160 mEq/L causes:
renal injury
pulm edema
seizures
cardiac dysfunction
hypertonic saline monitoring
serum Na
serum osmolarity
every 6 hrs***
which has higher risk, hypertonic saline or mannitol?
hypertonic saline
furosemide MOA
loop diuretic
blocking the sodium-potassium-chloride (Na-K-2Cl) cotransporter in the thick ascending limb of the loop of Henle in the kidney
furosemide indication
pt w/symptoms of high IV volume
aid tolerance of mannitol/hypertonic in pt w/CHF/nephrotic syndrom
corticosteroids are useful in what pts
lower ICP causedby localized vasogenic edema
(brain tumor / craniotomy)
corticosteroids MOA
upregulation of expression of proteins responsible for tight junctions in BBB
decadron dose
10 mg IV
