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Pharmacologic Strategies for the Treatment of Elevated Intracranial Pressure: Focus on Metabolic Suppression

Cook, Aaron M. PharmD, BCPS; Weant, Kyle A. PharmD, BCPS

Section Editor(s): Scott, Christopher M. PharmD, BCPS

doi: 10.1097/01.TME.0000300112.24819.5c
Applied Pharmacology

Elevations in intracranial pressure often occur after traumatic brain injury. A limited array of medications is available for the treatment of intracranial hypertension. Metabolic suppression agents may be used in this situation to suppress electrical activity in the brain, diminish the cerebral metabolic rate of oxygen consumption, and, as a consequence, decrease cerebral blood volume and intracranial pressure. Propofol and pentobarbital have unique characteristics that make each desirable, yet difficult to use in the setting of traumatic brain injury. The subject of this review is to discuss the role of these agents in treating refractory elevated intracranial pressure through metabolic suppression.

From the College of Pharmacy, University of Kentucky, Lexington (Dr Cook); and the School of Pharmacy, University of North Carolina, Chapel Hill (Dr Weant).

Corresponding author: Aaron M. Cook, PharmD, 800 Rose Street, H110, Lexington, KY 40536 (e-mail:

© 2007 Lippincott Williams & Wilkins, Inc.