Indications

• Increased Intracranial Pressure (ICP) (see Increased Intracranial Pressure, [[Increased Intracranial Pressure]])
  • Traumatic Brain Injury (TBI) (see Traumatic Brain Injury, [[Traumatic Brain Injury]])

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Pharmacology

• Barbiturate (see Barbiturates, [[Barbiturates]])

Metabolism

• xx

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Administration

• Load: 10 mg/kg over 30 min, 5 mg/kg q1hr x 3 doses (J Neurosurg, 1988) [MEDLINE]
• Maintenance: 1 mg/kg/hr (J Neurosurg, 1988) [MEDLINE]

Dose Adjustment

• Hepatic
• Renal

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Adverse Effects

Dermatologic Adverse Effects

• Erythema Multiforme (see Erythema Multiforme, [[Erythema Multiforme]])

Neurologic Adverse Effects

• Sedation

Pulmonary Adverse Effects

• Respiratory Depression
  • Acute Hypoventilation (see Acute Hypoventilation, [[Acute Hypoventilation]])
  • Chronic Hypoventilation (see Chronic Hypoventilation, [[Chronic Hypoventilation]])

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References

• High-dose barbiturate control of elevated intracranial pressure in patients with severe head injury. J Neurosurg. 1988 Jul;69(1):15-23 [MEDLINE]
• Sedation for critically ill adults with severe traumatic brain injury: a systematic review of randomized controlled trials. Crit Care Med. 2011;39:2743–2751 [MEDLINE]
• Sedation in traumatic brain injury. Emerg Med Int. 2012; vol 2012; article ID 637171, pp 1–11 [MEDLINE]