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

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

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

Advanced Emergency Nursing Journal: January-March 2008 - Volume 30 - Issue 1 - p 17–26
doi: 10.1097/01.TME.0000311542.95656.92
Applied Pharmacology

Cerebral edema is a significant cause of elevated intracranial pressure and a consequence of secondary injury following traumatic brain injury. The use of hyperosmolar agents has been theorized to reduce intracranial pressure through osmotic effects on the water content of the injured brain. The most commonly used agents for this purpose are mannitol and hypertonic saline. While these agents have demonstrated efficacy, prospective, randomized clinical data are somewhat limited. This article reviews the available data concerning the safety, efficacy, and monitoring of osmotic agents when used to treat elevated intracranial pressure.

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

Corresponding author: Kyle A. Weant, PharmD, BCPS, 101 Manning Dr, Chapel Hill, NC 27514 (e-mail:

© 2008 Lippincott Williams & Wilkins, Inc.