TBI TBI Pharmacological Management 2

Question 1

Propranolol is sometimes used post-TBI primarily to treat which condition?

Accepted Answer

Autonomic dysreflexia and sympathetic storming

Answer

Sympathetic storming (paroxysmal sympathetic hyperactivity) after TBI is often managed with propranolol to blunt adrenergic surges.

Question 2

Which medication is avoided in TBI due to its potential to lower the seizure threshold?

Accepted Answer

Tramadol

Answer

Tramadol lowers the seizure threshold and is generally avoided in TBI patients who are already at elevated seizure risk.

Question 3

What is the role of methylphenidate in post-acute TBI rehabilitation?

Accepted Answer

Improve attention, processing speed, and cognitive fatigue

Answer

Methylphenidate (Ritalin) is used off-label in TBI rehab to improve attention, alertness, and cognitive processing speed.

Question 4

Hypertonic saline is used in TBI management primarily as an alternative to which drug?

Accepted Answer

Mannitol

Answer

Hypertonic saline serves as an osmotic therapy alternative to mannitol for reducing elevated intracranial pressure.

Question 5

Why is corticosteroid use (e.g., dexamethasone) contraindicated in acute TBI?

Accepted Answer

The CRASH trial showed increased mortality with corticosteroids in TBI

Answer

The landmark CRASH trial demonstrated that methylprednisolone infusion in acute TBI significantly increased 2-week mortality.

TBI - Traumatic Brain Injury Certification Practice Test