Skip to main content
Top
Published in: Neurocritical Care 1/2017

01-09-2017

Pharmacotherapy Pearls for Emergency Neurological Life Support

Authors: Gretchen M. Brophy, Theresa Human

Published in: Neurocritical Care | Special Issue 1/2017

Login to get access

Abstract

The appropriate use of medications during Emergency Neurological Life Support (ENLS) is essential to optimize patient care. Important considerations when choosing the appropriate agent include the patient’s organ function and medication allergies, potential adverse drug effects, drug interactions and critical illness and aging pathophysiologic changes. Critical medications used during ENLS include hyperosmolar therapy, anticonvulsants, antithrombotics, anticoagulant reversal and hemostatic agents, anti-shivering agents, neuromuscular blockers, antihypertensive agents, sedatives, vasopressors and inotropes, and antimicrobials. This article focuses on the important pharmacokinetic and pharmacodynamics characteristics, advantages and disadvantages and clinical pearls of these therapies, providing practitioners with essential drug information to optimize pharmacotherapy in acutely ill neurocritical care patients.
Literature
1.
go back to reference Kamel H, Cornes SB, Hegde M, Hall SE, Josephson SA. Electroconvulsive therapy for refractory status epilepticus: a case series. Neurocrit Care. 2010;12(2):204–10.PubMedCrossRef Kamel H, Cornes SB, Hegde M, Hall SE, Josephson SA. Electroconvulsive therapy for refractory status epilepticus: a case series. Neurocrit Care. 2010;12(2):204–10.PubMedCrossRef
2.
go back to reference Hays AN, Lazaridis C, Neyens R, Nicholas J, Gay S, Chalela JA. Osmotherapy: use among neurointensivists. Neurocrit Care. 2011;14(2):222–8.PubMedCrossRef Hays AN, Lazaridis C, Neyens R, Nicholas J, Gay S, Chalela JA. Osmotherapy: use among neurointensivists. Neurocrit Care. 2011;14(2):222–8.PubMedCrossRef
3.
go back to reference Perez-Perez AJ, Pazos B, Sobrado J, Gonzalez L, Gandara A. Acute renal failure following massive mannitol infusion. Am J Nephrol. 2002;22(5–6):573–5.PubMedCrossRef Perez-Perez AJ, Pazos B, Sobrado J, Gonzalez L, Gandara A. Acute renal failure following massive mannitol infusion. Am J Nephrol. 2002;22(5–6):573–5.PubMedCrossRef
4.
go back to reference Gadallah MF, Lynn M, Work J. Case report: mannitol nephrotoxicity syndrome: role of hemodialysis and postulate of mechanisms. Am J Med Sci. 1995;309(4):219–22.PubMedCrossRef Gadallah MF, Lynn M, Work J. Case report: mannitol nephrotoxicity syndrome: role of hemodialysis and postulate of mechanisms. Am J Med Sci. 1995;309(4):219–22.PubMedCrossRef
5.
go back to reference Dorman HR, Sondheimer JH, Cadnapaphornchai P. Mannitol-induced acute renal failure. Medicine. 1990;69(3):153–9.PubMedCrossRef Dorman HR, Sondheimer JH, Cadnapaphornchai P. Mannitol-induced acute renal failure. Medicine. 1990;69(3):153–9.PubMedCrossRef
6.
go back to reference Gondim Fde A, Aiyagari V, Shackleford A, Diringer MN. Osmolality not predictive of mannitol-induced acute renal insufficiency. J Neurosurg. 2005;103(3):444–7.PubMedCrossRef Gondim Fde A, Aiyagari V, Shackleford A, Diringer MN. Osmolality not predictive of mannitol-induced acute renal insufficiency. J Neurosurg. 2005;103(3):444–7.PubMedCrossRef
7.
go back to reference Rudehill A, Gordon E, Ohman G, Lindqvist C, Andersson P. Pharmacokinetics and effects of mannitol on hemodynamics, blood and cerebrospinal fluid electrolytes, and osmolality during intracranial surgery. J Neurosurg Anesthesiol. 1993;5(1):4–12.PubMedCrossRef Rudehill A, Gordon E, Ohman G, Lindqvist C, Andersson P. Pharmacokinetics and effects of mannitol on hemodynamics, blood and cerebrospinal fluid electrolytes, and osmolality during intracranial surgery. J Neurosurg Anesthesiol. 1993;5(1):4–12.PubMedCrossRef
8.
go back to reference Palma L, Bruni G, Fiaschi AI, Mariottini A. Passage of mannitol into the brain around gliomas: a potential cause of rebound phenomenon. A study on 21 patients. J Neurosurg Sci. 2006;50(3):63–6.PubMed Palma L, Bruni G, Fiaschi AI, Mariottini A. Passage of mannitol into the brain around gliomas: a potential cause of rebound phenomenon. A study on 21 patients. J Neurosurg Sci. 2006;50(3):63–6.PubMed
9.
go back to reference Kheirbek T, Pascual JL. Hypertonic saline for the treatment of intracranial hypertension. Curr Neurol Neurosci Rep. 2014;14(9):482.PubMedCrossRef Kheirbek T, Pascual JL. Hypertonic saline for the treatment of intracranial hypertension. Curr Neurol Neurosci Rep. 2014;14(9):482.PubMedCrossRef
10.
go back to reference Forsyth LL, Liu-DeRyke X, Parker D Jr, Rhoney DH. Role of hypertonic saline for the management of intracranial hypertension after stroke and traumatic brain injury. Pharmacotherapy. 2008;28(4):469–84.PubMedCrossRef Forsyth LL, Liu-DeRyke X, Parker D Jr, Rhoney DH. Role of hypertonic saline for the management of intracranial hypertension after stroke and traumatic brain injury. Pharmacotherapy. 2008;28(4):469–84.PubMedCrossRef
11.
go back to reference Papangelou A, Lewin JJ 3rd, Mirski MA, Stevens RD. Pharmacologic management of brain edema. Curr Treat Options Neurol. 2009;11(1):64–73.PubMedCrossRef Papangelou A, Lewin JJ 3rd, Mirski MA, Stevens RD. Pharmacologic management of brain edema. Curr Treat Options Neurol. 2009;11(1):64–73.PubMedCrossRef
12.
go back to reference Roquilly A, Mahe PJ, Latte DD, Loutrel O, Champin P, Di Falco C, et al. Continuous controlled-infusion of hypertonic saline solution in traumatic brain-injured patients: a 9-year retrospective study. Crit Care. 2011;15(5):R260.PubMedPubMedCentralCrossRef Roquilly A, Mahe PJ, Latte DD, Loutrel O, Champin P, Di Falco C, et al. Continuous controlled-infusion of hypertonic saline solution in traumatic brain-injured patients: a 9-year retrospective study. Crit Care. 2011;15(5):R260.PubMedPubMedCentralCrossRef
13.
go back to reference Brophy GM, Bell R, Claassen J, Alldredge B, Bleck TP, Glauser T, et al. Guidelines for the evaluation and management of status epilepticus. Neurocrit Care. 2012;17(1):3–23.PubMedCrossRef Brophy GM, Bell R, Claassen J, Alldredge B, Bleck TP, Glauser T, et al. Guidelines for the evaluation and management of status epilepticus. Neurocrit Care. 2012;17(1):3–23.PubMedCrossRef
14.
15.
go back to reference Ubogu EE, Sagar SM, Lerner AJ, Maddux BN, Suarez JI, Werz MA. Ketamine for refractory status epilepticus: a case of possible ketamine-induced neurotoxicity. Epilepsy Behav: E&B. 2003;4(1):70–5.CrossRef Ubogu EE, Sagar SM, Lerner AJ, Maddux BN, Suarez JI, Werz MA. Ketamine for refractory status epilepticus: a case of possible ketamine-induced neurotoxicity. Epilepsy Behav: E&B. 2003;4(1):70–5.CrossRef
16.
go back to reference Furie KL, Kasner SE, Adams RJ, Albers GW, Bush RL, Fagan SC, et al. Guidelines for the prevention of stroke in patients with stroke or transient ischemic attack: a guideline for healthcare professionals from the american heart association/american stroke association. Stroke. 2011;42(1):227–76.PubMedCrossRef Furie KL, Kasner SE, Adams RJ, Albers GW, Bush RL, Fagan SC, et al. Guidelines for the prevention of stroke in patients with stroke or transient ischemic attack: a guideline for healthcare professionals from the american heart association/american stroke association. Stroke. 2011;42(1):227–76.PubMedCrossRef
17.
go back to reference Serebruany VL, Steinhubl SR, Berger PB, Malinin AI, Bhatt DL, Topol EJ. Variability in platelet responsiveness to clopidogrel among 544 individuals. J Am Coll Cardiol. 2005;45(2):246–51.PubMedCrossRef Serebruany VL, Steinhubl SR, Berger PB, Malinin AI, Bhatt DL, Topol EJ. Variability in platelet responsiveness to clopidogrel among 544 individuals. J Am Coll Cardiol. 2005;45(2):246–51.PubMedCrossRef
18.
go back to reference Levine GN, Bates ER, Blankenship JC, Bailey SR, Bittl JA, Cercek B, et al. 2011 ACCF/AHA/SCAI guideline for percutaneous coronary intervention. A report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines and the Society for Cardiovascular Angiography and Interventions. J Am Coll Cardiol. 2011;58(24):e44–122.PubMedCrossRef Levine GN, Bates ER, Blankenship JC, Bailey SR, Bittl JA, Cercek B, et al. 2011 ACCF/AHA/SCAI guideline for percutaneous coronary intervention. A report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines and the Society for Cardiovascular Angiography and Interventions. J Am Coll Cardiol. 2011;58(24):e44–122.PubMedCrossRef
19.
20.
go back to reference Lier H, Krep H, Schroeder S, Stuber F. Preconditions of hemostasis in trauma: a review. The influence of acidosis, hypocalcemia, anemia, and hypothermia on functional hemostasis in trauma. J Trauma. 2008;65(4):951–60.PubMedCrossRef Lier H, Krep H, Schroeder S, Stuber F. Preconditions of hemostasis in trauma: a review. The influence of acidosis, hypocalcemia, anemia, and hypothermia on functional hemostasis in trauma. J Trauma. 2008;65(4):951–60.PubMedCrossRef
21.
go back to reference Crowther MA, Warkentin TE. Managing bleeding in anticoagulated patients with a focus on novel therapeutic agents. J Thromb Haemost: JTH. 2009;7(Suppl 1):107–10.PubMedCrossRef Crowther MA, Warkentin TE. Managing bleeding in anticoagulated patients with a focus on novel therapeutic agents. J Thromb Haemost: JTH. 2009;7(Suppl 1):107–10.PubMedCrossRef
22.
go back to reference Leissinger CA, Blatt PM, Hoots WK, Ewenstein B. Role of prothrombin complex concentrates in reversing warfarin anticoagulation: a review of the literature. Am J Hematol. 2008;83(2):137–43.PubMedCrossRef Leissinger CA, Blatt PM, Hoots WK, Ewenstein B. Role of prothrombin complex concentrates in reversing warfarin anticoagulation: a review of the literature. Am J Hematol. 2008;83(2):137–43.PubMedCrossRef
23.
go back to reference Tran H, Collecutt M, Whitehead S, Salem HH. Prothrombin complex concentrates used alone in urgent reversal of warfarin anticoagulation. Int Med J. 2011;41(4):337–43.CrossRef Tran H, Collecutt M, Whitehead S, Salem HH. Prothrombin complex concentrates used alone in urgent reversal of warfarin anticoagulation. Int Med J. 2011;41(4):337–43.CrossRef
24.
go back to reference Frontera JA, Lewin JJ 3rd, Rabinstein AA, Aisiku IP, Alexandrov AW, Cook AM, et al. Guideline for reversal of antithrombotics in intracranial hemorrhage: a statement for healthcare professionals from the neurocritical care society and society of critical care medicine. Neurocrit Care. 2016;24(1):6–46.PubMedCrossRef Frontera JA, Lewin JJ 3rd, Rabinstein AA, Aisiku IP, Alexandrov AW, Cook AM, et al. Guideline for reversal of antithrombotics in intracranial hemorrhage: a statement for healthcare professionals from the neurocritical care society and society of critical care medicine. Neurocrit Care. 2016;24(1):6–46.PubMedCrossRef
25.
go back to reference Steiner T, Poli S, Griebe M, Husing J, Hajda J, Freiberger A, et al. Fresh frozen plasma versus prothrombin complex concentrate in patients with intracranial haemorrhage related to vitamin K antagonists (INCH): a randomised trial. Lancet Neurol. 2016;15(6):566–73.PubMedCrossRef Steiner T, Poli S, Griebe M, Husing J, Hajda J, Freiberger A, et al. Fresh frozen plasma versus prothrombin complex concentrate in patients with intracranial haemorrhage related to vitamin K antagonists (INCH): a randomised trial. Lancet Neurol. 2016;15(6):566–73.PubMedCrossRef
26.
go back to reference van Aart L, Eijkhout HW, Kamphuis JS, Dam M, Schattenkerk ME, Schouten TJ, et al. Individualized dosing regimen for prothrombin complex concentrate more effective than standard treatment in the reversal of oral anticoagulant therapy: an open, prospective randomized controlled trial. Thromb Res. 2006;118(3):313–20.PubMedCrossRef van Aart L, Eijkhout HW, Kamphuis JS, Dam M, Schattenkerk ME, Schouten TJ, et al. Individualized dosing regimen for prothrombin complex concentrate more effective than standard treatment in the reversal of oral anticoagulant therapy: an open, prospective randomized controlled trial. Thromb Res. 2006;118(3):313–20.PubMedCrossRef
27.
go back to reference Crawford JH, Augustson BM. Prothrombinex use for the reversal of warfarin: is fresh frozen plasma needed? Med J Aust. 2006;184(7):365–6.PubMed Crawford JH, Augustson BM. Prothrombinex use for the reversal of warfarin: is fresh frozen plasma needed? Med J Aust. 2006;184(7):365–6.PubMed
28.
go back to reference Dager WE. Using prothrombin complex concentrates to rapidly reverse oral anticoagulant effects. Ann Pharmacother. 2011;45(7–8):1016–20.PubMedCrossRef Dager WE. Using prothrombin complex concentrates to rapidly reverse oral anticoagulant effects. Ann Pharmacother. 2011;45(7–8):1016–20.PubMedCrossRef
29.
go back to reference Bershad EM, Suarez JI. Prothrombin complex concentrates for oral anticoagulant therapy-related intracranial hemorrhage: a review of the literature. Neurocrit Care. 2010;12(3):403–13.PubMedCrossRef Bershad EM, Suarez JI. Prothrombin complex concentrates for oral anticoagulant therapy-related intracranial hemorrhage: a review of the literature. Neurocrit Care. 2010;12(3):403–13.PubMedCrossRef
30.
go back to reference Holland L, Warkentin TE, Refaai M, Crowther MA, Johnston MA, Sarode R. Suboptimal effect of a three-factor prothrombin complex concentrate (Profilnine-SD) in correcting supratherapeutic international normalized ratio due to warfarin overdose. Transfusion. 2009;49(6):1171–7.PubMedCrossRef Holland L, Warkentin TE, Refaai M, Crowther MA, Johnston MA, Sarode R. Suboptimal effect of a three-factor prothrombin complex concentrate (Profilnine-SD) in correcting supratherapeutic international normalized ratio due to warfarin overdose. Transfusion. 2009;49(6):1171–7.PubMedCrossRef
31.
go back to reference Goldstein JN, Refaai MA, Milling TJ Jr, Lewis B, Goldberg-Alberts R, Hug BA, et al. Four-factor prothrombin complex concentrate versus plasma for rapid vitamin K antagonist reversal in patients needing urgent surgical or invasive interventions: a phase 3b, open-label, non-inferiority, randomised trial. Lancet. 2015;385:2077–87.PubMedCrossRef Goldstein JN, Refaai MA, Milling TJ Jr, Lewis B, Goldberg-Alberts R, Hug BA, et al. Four-factor prothrombin complex concentrate versus plasma for rapid vitamin K antagonist reversal in patients needing urgent surgical or invasive interventions: a phase 3b, open-label, non-inferiority, randomised trial. Lancet. 2015;385:2077–87.PubMedCrossRef
32.
go back to reference Weibert RT, Le DT, Kayser SR, Rapaport SI. Correction of excessive anticoagulation with low-dose oral vitamin K1. Ann Intern Med. 1997;126(12):959–62.PubMedCrossRef Weibert RT, Le DT, Kayser SR, Rapaport SI. Correction of excessive anticoagulation with low-dose oral vitamin K1. Ann Intern Med. 1997;126(12):959–62.PubMedCrossRef
33.
go back to reference Brophy MT, Fiore LD, Deykin D. Low-dose vitamin K therapy in excessively anticoagulated patients: a dose-finding study. J Thromb Thrombolysis. 1997;4(2):289–92.PubMedCrossRef Brophy MT, Fiore LD, Deykin D. Low-dose vitamin K therapy in excessively anticoagulated patients: a dose-finding study. J Thromb Thrombolysis. 1997;4(2):289–92.PubMedCrossRef
34.
go back to reference Lubetsky A, Yonath H, Olchovsky D, Loebstein R, Halkin H, Ezra D. Comparison of oral vs intravenous phytonadione (vitamin K1) in patients with excessive anticoagulation: a prospective randomized controlled study. Arch Intern Med. 2003;163(20):2469–73.PubMedCrossRef Lubetsky A, Yonath H, Olchovsky D, Loebstein R, Halkin H, Ezra D. Comparison of oral vs intravenous phytonadione (vitamin K1) in patients with excessive anticoagulation: a prospective randomized controlled study. Arch Intern Med. 2003;163(20):2469–73.PubMedCrossRef
35.
go back to reference Nee R, Doppenschmidt D, Donovan DJ, Andrews TC. Intravenous versus subcutaneous vitamin K1 in reversing excessive oral anticoagulation. Am J Cardiol. 1999;83(2):286–8 (A6–7).PubMedCrossRef Nee R, Doppenschmidt D, Donovan DJ, Andrews TC. Intravenous versus subcutaneous vitamin K1 in reversing excessive oral anticoagulation. Am J Cardiol. 1999;83(2):286–8 (A6–7).PubMedCrossRef
36.
go back to reference Pollack CV Jr. Evidence supporting idarucizumab for the reversal of dabigatran. Am J Emerg Med. 2016;34(11S):33–8.PubMedCrossRef Pollack CV Jr. Evidence supporting idarucizumab for the reversal of dabigatran. Am J Emerg Med. 2016;34(11S):33–8.PubMedCrossRef
37.
go back to reference Reilly PA, van Ryn J, Grottke O, Glund S, Stangier J. Idarucizumab, a specific reversal agent for dabigatran: mode of action, pharmacokinetics and pharmacodynamics, and safety and efficacy in phase 1 subjects. Am J Emerg Med. 2016;34(11S):26–32.PubMedCrossRef Reilly PA, van Ryn J, Grottke O, Glund S, Stangier J. Idarucizumab, a specific reversal agent for dabigatran: mode of action, pharmacokinetics and pharmacodynamics, and safety and efficacy in phase 1 subjects. Am J Emerg Med. 2016;34(11S):26–32.PubMedCrossRef
38.
go back to reference Teleb M, Salire K, Wardi M, Alkhateeb H, Said S, Mukherjee D. Idarucizumab: clinical role of a novel reversal agent for dabigatran. Cardiovasc Hematol Disord Drug Targets. 2016;16(1):25–9.PubMedCrossRef Teleb M, Salire K, Wardi M, Alkhateeb H, Said S, Mukherjee D. Idarucizumab: clinical role of a novel reversal agent for dabigatran. Cardiovasc Hematol Disord Drug Targets. 2016;16(1):25–9.PubMedCrossRef
39.
go back to reference Eerenberg ES, Kamphuisen PW, Sijpkens MK, Meijers JC, Buller HR, Levi M. Reversal of rivaroxaban and dabigatran by prothrombin complex concentrate: a randomized, placebo-controlled, crossover study in healthy subjects. Circulation. 2011;124(14):1573–9.PubMedCrossRef Eerenberg ES, Kamphuisen PW, Sijpkens MK, Meijers JC, Buller HR, Levi M. Reversal of rivaroxaban and dabigatran by prothrombin complex concentrate: a randomized, placebo-controlled, crossover study in healthy subjects. Circulation. 2011;124(14):1573–9.PubMedCrossRef
40.
go back to reference Wang JJ, Gosselin S, Villeneuve E. Andexanet alfa for factor Xa inhibitor reversal. N Engl J Med. 2016;375(25):2498.PubMedCrossRef Wang JJ, Gosselin S, Villeneuve E. Andexanet alfa for factor Xa inhibitor reversal. N Engl J Med. 2016;375(25):2498.PubMedCrossRef
41.
go back to reference Connolly SJ, Milling TJ Jr, Eikelboom JW, Gibson CM, Curnutte JT, Gold A, et al. Andexanet alfa for acute major bleeding associated with factor Xa inhibitors. N Engl J Med. 2016;375(12):1131–41.PubMedPubMedCentralCrossRef Connolly SJ, Milling TJ Jr, Eikelboom JW, Gibson CM, Curnutte JT, Gold A, et al. Andexanet alfa for acute major bleeding associated with factor Xa inhibitors. N Engl J Med. 2016;375(12):1131–41.PubMedPubMedCentralCrossRef
42.
go back to reference Mayer SA, Brun NC, Begtrup K, Broderick J, Davis S, Diringer MN, et al. Efficacy and safety of recombinant activated factor VII for acute intracerebral hemorrhage. N Engl J Med. 2008;358(20):2127–37.PubMedCrossRef Mayer SA, Brun NC, Begtrup K, Broderick J, Davis S, Diringer MN, et al. Efficacy and safety of recombinant activated factor VII for acute intracerebral hemorrhage. N Engl J Med. 2008;358(20):2127–37.PubMedCrossRef
43.
go back to reference Morgenstern LB, Hemphill JC 3rd, Anderson C, Becker K, Broderick JP, Connolly ES Jr, et al. Guidelines for the management of spontaneous intracerebral hemorrhage: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2010;41(9):2108–29.PubMedPubMedCentralCrossRef Morgenstern LB, Hemphill JC 3rd, Anderson C, Becker K, Broderick JP, Connolly ES Jr, et al. Guidelines for the management of spontaneous intracerebral hemorrhage: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2010;41(9):2108–29.PubMedPubMedCentralCrossRef
44.
go back to reference Holbrook A, Schulman S, Witt DM, Vandvik PO, Fish J, Kovacs MJ, et al. Evidence-based management of anticoagulant therapy: antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest. 2012;141(2 Suppl):e152S–84S.PubMedPubMedCentralCrossRef Holbrook A, Schulman S, Witt DM, Vandvik PO, Fish J, Kovacs MJ, et al. Evidence-based management of anticoagulant therapy: antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest. 2012;141(2 Suppl):e152S–84S.PubMedPubMedCentralCrossRef
45.
go back to reference Baglin TP, Keeling DM, Watson HG. Guidelines on oral anticoagulation (warfarin): third edition—2005 update. Br J Haematol. 2006;132(3):277–85.PubMedCrossRef Baglin TP, Keeling DM, Watson HG. Guidelines on oral anticoagulation (warfarin): third edition—2005 update. Br J Haematol. 2006;132(3):277–85.PubMedCrossRef
46.
go back to reference Baharoglu MI, Cordonnier C, Al-Shahi Salman R, de Gans K, Koopman MM, Brand A, et al. Platelet transfusion versus standard care after acute stroke due to spontaneous cerebral haemorrhage associated with antiplatelet therapy (PATCH): a randomised, open-label, phase 3 trial. Lancet. 2016;387(10038):2605–13.PubMedCrossRef Baharoglu MI, Cordonnier C, Al-Shahi Salman R, de Gans K, Koopman MM, Brand A, et al. Platelet transfusion versus standard care after acute stroke due to spontaneous cerebral haemorrhage associated with antiplatelet therapy (PATCH): a randomised, open-label, phase 3 trial. Lancet. 2016;387(10038):2605–13.PubMedCrossRef
47.
go back to reference Monte AA, Bodmer M, Schaeffer TH. Low-molecular-weight heparin overdose: management by observation. Ann Pharmacother. 2010;44(11):1836–9.PubMedCrossRef Monte AA, Bodmer M, Schaeffer TH. Low-molecular-weight heparin overdose: management by observation. Ann Pharmacother. 2010;44(11):1836–9.PubMedCrossRef
48.
go back to reference Bordes J, Asencio Y, Kenane N, Fesselet J, Meaudre E, Goutorbe P. Recombinant activated factor VII for acute subdural haematoma in an elderly patient taking fondaparinux. Br J Anaesth. 2008;101(4):575–6.PubMedCrossRef Bordes J, Asencio Y, Kenane N, Fesselet J, Meaudre E, Goutorbe P. Recombinant activated factor VII for acute subdural haematoma in an elderly patient taking fondaparinux. Br J Anaesth. 2008;101(4):575–6.PubMedCrossRef
49.
go back to reference Harrigan MR, Rajneesh KF, Ardelt AA, Fisher WS 3rd. Short-term antifibrinolytic therapy before early aneurysm treatment in subarachnoid hemorrhage: effects on rehemorrhage, cerebral ischemia, and hydrocephalus. Neurosurgery. 2010;67(4):935–9 ; discussion 9–40.PubMedCrossRef Harrigan MR, Rajneesh KF, Ardelt AA, Fisher WS 3rd. Short-term antifibrinolytic therapy before early aneurysm treatment in subarachnoid hemorrhage: effects on rehemorrhage, cerebral ischemia, and hydrocephalus. Neurosurgery. 2010;67(4):935–9 ; discussion 9–40.PubMedCrossRef
50.
go back to reference Schuette AJ, Hui FK, Obuchowski NA, Walkup RR, Cawley CM, Barrow DL, et al. An examination of aneurysm rerupture rates with epsilon aminocaproic acid. Neurocrit Care. 2013;19(1):48–55.PubMedCrossRef Schuette AJ, Hui FK, Obuchowski NA, Walkup RR, Cawley CM, Barrow DL, et al. An examination of aneurysm rerupture rates with epsilon aminocaproic acid. Neurocrit Care. 2013;19(1):48–55.PubMedCrossRef
51.
go back to reference Starke RM, Kim GH, Fernandez A, Komotar RJ, Hickman ZL, Otten ML, et al. Impact of a protocol for acute antifibrinolytic therapy on aneurysm rebleeding after subarachnoid hemorrhage. Stroke. 2008;39(9):2617–21.PubMedCrossRef Starke RM, Kim GH, Fernandez A, Komotar RJ, Hickman ZL, Otten ML, et al. Impact of a protocol for acute antifibrinolytic therapy on aneurysm rebleeding after subarachnoid hemorrhage. Stroke. 2008;39(9):2617–21.PubMedCrossRef
52.
go back to reference Kurz A, Plattner O, Sessler DI, Huemer G, Redl G, Lackner F. The threshold for thermoregulatory vasoconstriction during nitrous oxide/isoflurane anesthesia is lower in elderly than in young patients. Anesthesiology. 1993;79(3):465–9.PubMedCrossRef Kurz A, Plattner O, Sessler DI, Huemer G, Redl G, Lackner F. The threshold for thermoregulatory vasoconstriction during nitrous oxide/isoflurane anesthesia is lower in elderly than in young patients. Anesthesiology. 1993;79(3):465–9.PubMedCrossRef
53.
go back to reference Badjatia N, Strongilis E, Gordon E, Prescutti M, Fernandez L, Fernandez A, et al. Metabolic impact of shivering during therapeutic temperature modulation: the Bedside Shivering Assessment Scale. Stroke. 2008;39(12):3242–7.PubMedCrossRef Badjatia N, Strongilis E, Gordon E, Prescutti M, Fernandez L, Fernandez A, et al. Metabolic impact of shivering during therapeutic temperature modulation: the Bedside Shivering Assessment Scale. Stroke. 2008;39(12):3242–7.PubMedCrossRef
54.
go back to reference Mokhtarani M, Mahgoub AN, Morioka N, Doufas AG, Dae M, Shaughnessy TE, et al. Buspirone and meperidine synergistically reduce the shivering threshold. Anesth Analg. 2001;93(5):1233–9.PubMedCrossRef Mokhtarani M, Mahgoub AN, Morioka N, Doufas AG, Dae M, Shaughnessy TE, et al. Buspirone and meperidine synergistically reduce the shivering threshold. Anesth Analg. 2001;93(5):1233–9.PubMedCrossRef
55.
go back to reference Talke P, Tayefeh F, Sessler DI, Jeffrey R, Noursalehi M, Richardson C. Dexmedetomidine does not alter the sweating threshold, but comparably and linearly decreases the vasoconstriction and shivering thresholds. Anesthesiology. 1997;87(4):835–41.PubMedCrossRef Talke P, Tayefeh F, Sessler DI, Jeffrey R, Noursalehi M, Richardson C. Dexmedetomidine does not alter the sweating threshold, but comparably and linearly decreases the vasoconstriction and shivering thresholds. Anesthesiology. 1997;87(4):835–41.PubMedCrossRef
56.
go back to reference Lysakowski C, Dumont L, Czarnetzki C, Tramer MR. Magnesium as an adjuvant to postoperative analgesia: a systematic review of randomized trials. Anesth Analg. 2007;104(6):1532–9 (table of contents).PubMedCrossRef Lysakowski C, Dumont L, Czarnetzki C, Tramer MR. Magnesium as an adjuvant to postoperative analgesia: a systematic review of randomized trials. Anesth Analg. 2007;104(6):1532–9 (table of contents).PubMedCrossRef
57.
go back to reference Badjatia N, Kowalski RG, Schmidt JM, Voorhees ME, Claassen J, Ostapkovich ND, et al. Predictors and clinical implications of shivering during therapeutic normothermia. Neurocrit Care. 2007;6(3):186–91.PubMedCrossRef Badjatia N, Kowalski RG, Schmidt JM, Voorhees ME, Claassen J, Ostapkovich ND, et al. Predictors and clinical implications of shivering during therapeutic normothermia. Neurocrit Care. 2007;6(3):186–91.PubMedCrossRef
58.
go back to reference Murray MJ, DeBlock H, Erstad B, Gray A, Jacobi J, Jordan C, et al. Clinical practice guidelines for sustained neuromuscular blockade in the adult critically Ill patient. Crit Care Med. 2016;44(11):2079–103.PubMedCrossRef Murray MJ, DeBlock H, Erstad B, Gray A, Jacobi J, Jordan C, et al. Clinical practice guidelines for sustained neuromuscular blockade in the adult critically Ill patient. Crit Care Med. 2016;44(11):2079–103.PubMedCrossRef
60.
go back to reference Jacobi J, Fraser GL, Coursin DB, Riker RR, Fontaine D, Wittbrodt ET, et al. Clinical practice guidelines for the sustained use of sedatives and analgesics in the critically ill adult. Crit Care Med. 2002;30(1):119–41.PubMedCrossRef Jacobi J, Fraser GL, Coursin DB, Riker RR, Fontaine D, Wittbrodt ET, et al. Clinical practice guidelines for the sustained use of sedatives and analgesics in the critically ill adult. Crit Care Med. 2002;30(1):119–41.PubMedCrossRef
61.
go back to reference Devlin JW, Roberts RJ. Pharmacology of commonly used analgesics and sedatives in the ICU: benzodiazepines, propofol, and opioids. Crit Care Clin. 2009;25(3):431–49 (vii).PubMedCrossRef Devlin JW, Roberts RJ. Pharmacology of commonly used analgesics and sedatives in the ICU: benzodiazepines, propofol, and opioids. Crit Care Clin. 2009;25(3):431–49 (vii).PubMedCrossRef
62.
go back to reference Mullner M, Urbanek B, Havel C, Losert H, Waechter F, Gamper G. Vasopressors for shock. Cochrane Database Syst Rev. 2004;3:CD003709. Mullner M, Urbanek B, Havel C, Losert H, Waechter F, Gamper G. Vasopressors for shock. Cochrane Database Syst Rev. 2004;3:CD003709.
63.
go back to reference Sookplung P, Siriussawakul A, Malakouti A, Sharma D, Wang J, Souter MJ, et al. Vasopressor use and effect on blood pressure after severe adult traumatic brain injury. Neurocrit Care. 2011;15(1):46–54.PubMedPubMedCentralCrossRef Sookplung P, Siriussawakul A, Malakouti A, Sharma D, Wang J, Souter MJ, et al. Vasopressor use and effect on blood pressure after severe adult traumatic brain injury. Neurocrit Care. 2011;15(1):46–54.PubMedPubMedCentralCrossRef
64.
go back to reference van de Beek D, de Gans J, McIntyre P, Prasad K. Corticosteroids for acute bacterial meningitis. Cochrane Database Syst Rev. 2007;1:CD004405. van de Beek D, de Gans J, McIntyre P, Prasad K. Corticosteroids for acute bacterial meningitis. Cochrane Database Syst Rev. 2007;1:CD004405.
65.
go back to reference van de Beek D, Drake JM, Tunkel AR. Nosocomial bacterial meningitis. N Engl J Med. 2010;362(2):146–54.PubMedCrossRef van de Beek D, Drake JM, Tunkel AR. Nosocomial bacterial meningitis. N Engl J Med. 2010;362(2):146–54.PubMedCrossRef
Metadata
Title
Pharmacotherapy Pearls for Emergency Neurological Life Support
Authors
Gretchen M. Brophy
Theresa Human
Publication date
01-09-2017
Publisher
Springer US
Published in
Neurocritical Care / Issue Special Issue 1/2017
Print ISSN: 1541-6933
Electronic ISSN: 1556-0961
DOI
https://doi.org/10.1007/s12028-017-0456-x

Other articles of this Special Issue 1/2017

Neurocritical Care 1/2017 Go to the issue