Neurological Disorders Q 9 - Gyan Darpan : Learning Portal
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Wednesday, 20 April 2022

Neurological Disorders Q 9

A client is admitted with a spinal cord injury at the level of T12. He has limited movement of his upper extremities. Which of the following medications would be used to control edema of the spinal cord?
     A. acetazolamide (Diamox)
     B. furosemide (Lasix)
     C. methylprednisolone (Solu-Medrol)
     D. sodium bicarbonate

Correct Answer: C. Methylprednisolone (Solu-Medrol)

High doses of Solu-Medrol are used within 24 hours of spinal injury to reduce cord swelling and limit neurological deficit. The other drugs aren’t indicated in this circumstance. Methylprednisolone and its derivatives, methylprednisolone acetate succinate, and methylprednisolone sodium, are intermediate-acting, synthetic glucocorticoids used mainly as anti-inflammatory or immunosuppressive agents. Methylprednisolone is five times more potent in its anti-inflammatory properties relative to hydrocortisone (cortisol), with minimal mineralocorticoid activities compared to the latter.

Option A: Acetazolamide is a diuretic and carbonic anhydrase inhibitor medication that is used to treat several illnesses. Acetazolamide is a classic treatment option for glaucoma as it causes a reduction in the aqueous humor. As well, it is useful for the treatment of altitude sickness, because of its underlying mechanism of action. The medication works to excrete bicarbonate.
Option B: The Food and Drug Administration (FDA) has approved the use of furosemide in the treatment of conditions with volume overload and edema secondary to congestive heart failure exacerbation, liver failure, or renal failure including the nephrotic syndrome.
Option D: The main therapeutic effect of sodium bicarbonate administration is in increasing plasma bicarbonate levels, which are known to buffer excess hydrogen ion concentration, thereby raising solution pH to combat clinical manifestations of acidosis.

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