A 25-year-old is admitted with loss of consciousness after cocaine over-dosage. On examination BP= 200/100 with GCS of 7/15. The right-sided pupil is dilated and shows a sluggish reaction to light. Which is not recommended for this patient?
Correct Answer: Initiate sodium nitroprusside to achieve MAP below 130 mmHg
Description: CNS bleed due to a cocaine overdose. The dilated right side pupil indicates evidence of uncal herniation. Sodium nitroprusside is not recommended to manage a hypeensive crisis in CNS event. The metabolism of sodium nitroprusside, which occurs in the red blood cell, liberates cyanide that can accumulate in those receiving high doses or prolonged infusions. The current guidelines recommend the use of nicardipine or labetalol. Mannitol or 3% saline can be used to lower raised ICP. Neuromuscular paralysis is useful to reduce ICP.Airway compromise is always present in GCS less than 8. Hence NM paralysis and intubation is to be done.
Category:
Medicine
Get More
Subject Mock Tests
Practice with over 200,000 questions from various medical subjects and improve your knowledge.
Attempt a mock test nowMock Exam
Take an exam with 100 random questions selected from all subjects to test your knowledge.
Coming SoonGet More
Subject Mock Tests
Try practicing mock tests with over 200,000 questions from various medical subjects.
Attempt a mock test now