Oral intracranial pressure-lowering drugs for brain cancer

When the intracranial volume increases due to multiple pathogenic factors and the cerebrospinal fluid pressure measured by lumbar puncture in the lateral position exceeds 2 kPa, it is called increased intracranial pressure. If a series of clinical manifestations such as headache, vomiting, visual impairment and papilledema occur, it is called increased intracranial pressure syndrome. So how to reduce intracranial pressure?

Dehydration therapy. Dehydration therapy is the key to reducing intracranial pressure, alleviating brain edema, and preventing brain herniation. Adults often use 250 ml of 20% mannitol, which is dripped quickly every 4 to 6 hours. The main reason is that the hypertonic solution forms an osmotic pressure difference between the blood and the brain, and transfers the water in the brain into the blood circulation as quickly as possible, not simply through diuresis.

Patients with heart and kidney dysfunction should use it with caution to prevent pulmonary edema and aggravation of heart and kidney failure. Mannitol can not only reduce intracranial pressure and alleviate cerebral edema, but also improve brain and systemic circulation, prevent the generation of free radicals, enhance the ability of nerve cells to tolerate hypoxia, and promote the recovery of brain function.

500 ml of 10% glycerol glucose solution or 10% glycerol saline solution should be dripped intravenously within 2 to 3 hours, 1 to 2 times a day, or 1 gram/kg per day, mixed with an equal amount of saline or orange juice, and taken orally or nasogastrically in three doses.

Glycerol intravenous drip or oral administration is mostly used for patients with chronic intracranial hypertension. The dose of hyperosmotic dehydrating agent should be properly controlled, not the larger the better. Generally, blood osmotic pressure rises by 31mosm. If a large dose of mannitol is used to make blood osmotic pressure greater than 310mosm, it may cause acidosis, renal failure and hyperosmotic coma.