TBI-08 · Pharmacology After TBI

Pharmacology After TBI. Part of the Traumatic Brain Injury series of the Reflex PM&R Board Review podcast. Audio corrections: (1) In the audio: During those four active weeks the patients on amantadine improved four points per week faster than the placebo group. — Correct: 0.24 points per week on the Disability Rating Scale (p=0.007), not four points per week. Four points/week over four weeks would imply an implausible 16-point swing on the 0-29 scale. (2) In the audio: Just to refresh those, the guidelines say keep ICP under 22 millimeters of mercury, keep CPP between 60 and 70, use mannitol for serum osmolality under 320, and cap seizure prophylaxis at seven days. — Correct: Three of those four are Brain Trauma Foundation numbers; the mannitol osmolality ceiling is not. The fourth edition found the evidence insufficient to make any hyperosmolar recommendation and prints no osmolality threshold, and later work found that exceeding 320 mOsm/L did not change the incidence of acute kidney injury. ICP 22 mmHg, CPP 60 to 70 mmHg and 7 days of seizure prophylaxis are correct as stated; there is no fourth number to recite beside them. The written chapter is correct. Full correction register: https://www.reflexpmr.com/errata. The full companion chapter and a linked board-style Q-bank set for this topic are at https://www.reflexpmr.com/read/TBI-08.