TBI TBI Pharmacological Management 3

Question 1

Which medication is prescribed for post-TBI headache that is refractory to standard analgesics?

Accepted Answer

Amitriptyline

Answer

Amitriptyline (a tricyclic antidepressant) is commonly used for prophylaxis of chronic post-traumatic headache.

Question 2

What is the main pharmacological goal when managing elevated ICP in a TBI patient?

Accepted Answer

Reduce ICP while maintaining adequate cerebral perfusion pressure

Answer

Management aims to lower ICP while ensuring CPP remains adequate (typically >60 mmHg) to prevent secondary ischemic injury.

Question 3

Donepezil (an acetylcholinesterase inhibitor) is sometimes used post-TBI to address which deficit?

Accepted Answer

Memory and cognitive impairment

Answer

Donepezil enhances cholinergic transmission and has shown benefit for memory and attention in moderate-to-severe TBI patients.

Question 4

Why must antidepressants be used cautiously during the early post-TBI period?

Accepted Answer

Many lower seizure threshold and can worsen cognitive function acutely

Answer

Some antidepressants (especially TCAs and bupropion) lower seizure threshold, which is hazardous in the already seizure-prone acute TBI brain.

Question 5

Zolpidem has been reported to paradoxically improve arousal in some minimally conscious TBI patients due to what mechanism?

Accepted Answer

It paradoxically inhibits overactive inhibitory pathways, releasing functional circuits

Answer

The paradoxical awakening effect of zolpidem in some MCS patients is thought to result from inhibition of dysfunctional over-inhibited thalamic circuits.

TBI - Traumatic Brain Injury Certification Practice Test

TBI - Traumatic Brain Injury Certification Practice Test

TBI TBI Pharmacological Management 3