A closed head injury patient is receiving mechanical ventilation ...

[Melani1276]

A closed head injury patient is receiving mechanical ventilation in the ICU. The patient remains somewhat agitated. Which of the following medications would be most appropriate for this patient?
 
  A. benzodiazepine
  B. propofol
  C. dexmedetomidine
  D. fentanyl

Question 2

A patient is about to have a spontaneous breathing trial after several weeks of PC-SIMV with PSV. The patient is a bit anxious about breathing without the assistance of the ventilator. Which of the following medications would be appropriate for this patient?
 
  A. midazolam
  B. haloperidol
  C. dexmedetomidine
  D. benzodiazepine

[jointhecircus]

Answer to Question 1

ANS: B
A. Incorrect response: See explanation B.
B. Correct response: Propofol is an IV anesthetic agent that is useful for sedation when titrated at lower doses. In addition to being used for its anticonvulsant properties, propofol is used to reduce elevated intracranial pressures. Propofol has a rapid onset and offset of action, making it excellent for patients expected to undergo a short course of mechanical ventilation.
C. Incorrect response: See explanation B.
D. Incorrect response: See explanation B.

Answer to Question 2

ANS: C
A. Incorrect response: Midazolam is a benzodiazepine that is used for patient sedation.
B. Incorrect response: Haloperidol is used for the treatment of acute psychotic states and delirium.
C. Correct response: Dexmedetomidine exhibits sedative, analgesic, and sympatholytic properties. Despite being sedated, patients remain easily arousable. The drug also provides anxiolysis with little respiratory depression or hemodynamic instability. This property is useful in patients in whom spontaneous breathing trials are hampered by anxiety and agitation.
D. Incorrect response: Benzodiazepines are drugs used for sedation and antegrade amnesia. Drugs included in this class are midazolam and diazepam.