Drugs to know in the Neuro Icu

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Hi everyone,

I am a new graduate RN who was just hired into a neuro-surgical intensive care unit. My manager said that I should brush up on my neuro A & P as well as review some of the more commonly used medications. He mentioned steroids and anti-hypertensives as important. I was hoping someone would be willing to share with me a brief list of the most commonly used medications so I can begin reviewing. I would also appreciate any tips or advice you may have for a new nurse in this setting.

Thanks a lot!

AstarteRN

Specializes in Cardiac nursing.

and I believe that is all you need to know for the first 12 months in Neuro ICU. Remember, this is a journey. Have faith and do not be afraid to ask questions. Good nurses know when to ask.

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Specializes in critical care, neuro.

I was going to write a list for you but this is basically every single med I would say.

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Specializes in Neuro ICU, SICU.

In our Neurosurgical ICU the most common drugs are as follows:

Nimotop

Decadron

Keppra

3% and 7.5% Sodium

Potassium

Tylenol for fever

Mannitol

Levophed for low BP

Cardene for high BP

Labetalol

Hydralazine

Primacor for cerebral vasospasms (dilates the cerebral vessels)

Norco

Morphine

Propofol

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Specializes in ICU.

We use a lot of 3% saline, keppra and dexamethasone. Occasionally we will see a nimodipine infusion. Other than that, just our normal ICU drugs.

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Specializes in ICU.

What has been your experience with Cleviprex for pressure and Precedex for sedation in neuro patients? Just curious...Aloha!

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Specializes in Critical Care.
What has been your experience with Cleviprex for pressure and Precedex for sedation in neuro patients? Just curious...Aloha!

We use precedex occasionally because it has less effect on ICP than propofol. We try to use propofol as little as possible.

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Our order sets usually have nicardipine as our go to for BP. We usually use precedex as an adjunct to other sedation, and is particularly useful in pts who are EtOHers. I also see DDAVP or desmopressin used for pts with DI. Keppra mainly used for seizure prophylaxis. And all the other meds people have mentioned. I hate mannitol, our lab takes forever to get back the osmo level for some reason I always end up hanging it late.

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Congrats on the icu job miguelli!! ?

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One drug that I would look at would be Ketamine, it's technically an anesthetic drug, but we use it a lot for stopping patient in status epilepticus.

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mark！

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Specializes in ICU.

I have read these in neuro ICU books but have not given it in our unit. Can nurses push or use ketamine as a gtt at the bedside? Since it is an anesthetic drug, are CRNAs or anethesiologists have to be a the bedside when this drug is being administered? This is all in assumption that the pt is already intubated...

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Specializes in ICU.
One drug that I would look at would be Ketamine, it's technically an anesthetic drug, but we use it a lot for stopping patient in status epilepticus.

I have read these in neuro ICU books but have not given it in our unit. Can nurses push or use ketamine as a gtt at the bedside? Since it is an anesthetic drug, are CRNAs or anethesiologists have to be a the bedside when this drug is being administered? This is all in assumption that the pt is already intubated...

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