A patient with head trauma and an elevated ICP is being ...

[yoooooman]

A patient with head trauma and an elevated ICP is being ventilated postoperatively and shows signs of asynchrony with the mechanical ventilator. The most appropriate medication to sedate this patient is which of the following?
 
  a. Morphine
  b. Propofol
  c. Propofol and morphine
  d. Fentanyl

Question 2

A patient who is receiving mechanical ventilation in the ICU is found to be wildly agitated. The most appropriate drug to control this delirium is which of the following?
 
  a. Propofol
  b. Fentanyl
  c. Haloperidol
  d. Lorazepam

[brbarasa]

Answer to Question 1

ANS: C
Propofol and morphine, administered simultaneously, allow for greater control of the ICP than morphine alone. Propofol reduces cerebral blood flow and intracranial pressure, making it a use-ful sedative for neurosurgical patients. In fact, propofol has been shown to be more effective than fentanyl in reducing ICP in patients with traumatic brain injury.

Answer to Question 2

ANS: C
Neuroleptics, such as haloperidol, are routinely used to treat patients demonstrating extreme agi-tation and delirium. Propofol is a general anesthetic used for sedation. Fentanyl is a synthetic opioid that is approximately 100-150 times more potent than morphine. Lorazepam (Ativan) is the drug of choice for sedating mechanically ventilated patients in the ICU for longer than 24 hours.