You are caring for a patient with increased intracranial pressure due to subdural hemorrhage. Which of the following drugs would you expect to be ordered by the HCP?

A. Mannitol is correct because it is an osmotic diuretic commonly used to reduce intracranial pressure. Mannitol increases plasma osmolality, drawing water out of cerebral tissue and into the intravascular space, which decreases cerebral edema and lowers ICP. It is frequently ordered in patients with increased ICP due to intracranial bleeding, such as a subdural hemorrhage. B. Ibuprofen is incorrect because nonsteroidal anti-inflammatory drugs increase the risk of bleeding and do not reduce intracranial pressure. In a patient with an active intracranial hemorrhage, ibuprofen may worsen bleeding and is contraindicated. C. IV heparin is incorrect because anticoagulants increase the risk of continued or worsening intracranial bleeding. Heparin would be avoided in a patient with a subdural hemorrhage unless there is a compelling and unrelated indication. D. Warfarin is incorrect because it is an oral anticoagulant that significantly increases bleeding risk. In the setting of a subdural hemorrhage and increased ICP, warfarin would worsen hemorrhage and is contraindicated.