Originally Posted by JohnW
Is it common for you guys to use nipride for heads? Some of our neurosurgeons try to stay clear of it citing a risk of increased ICP.
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The fact that the patient actually tolerated the lopressor gtt (per you, her HR dropped from the mid50 to mid40) I would actually think that this is a person who in not BB niaeve and probably needs some blockade. I would probably have grabbed some nitro, but with the idea that esmolol or labetlol would probably be needed once the lopressor wore off. I would probably (assuming you a NGT and there are no other issue) be looking to start some PO hypertensives asap, - then a drug like hydralzine can used for "breakthrough" hypertension.
Also, in terms of the metrop gtt, that's a huge drug error and I hope you filled an incident report. These are the types of errors that kill people. Please watch out for your patients and make sure this series of errors can't happen again.
Nipride
Adverse effects
Abdominal pain, bradycardia, coma, decreased platelet aggregation, flushing, headache,ileus, increased ICP, muscle twitching, restlessmess.
Contraindications Inadequate cerebral circulation
Interesting........but, then again, it's an SAH vs cerebral
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