A 55-old woman with aneurysmal subarachnoid hemorrhage is started on a calcium channel blocker to prevent cerebral vasospasm. What is the standard oral dosing regimen of this drug?
- A Nifedipine 20 mg twice daily for 21 days
- B Nimodipine 30 mg every 8 hours for 14 days
- C Nimodipine 60 mg every 4 hours for 21 days ✓
- D Verapamil 80 mg every 8 hours for 14 days
Correct answer: C. Nimodipine 60 mg every 4 hours for 21 days
Explanation
Nimodipine 60 mg orally (or via nasogastric tube) every 4 hours for 21 days is the standard regimen proven to improve outcomes after aneurysmal subarachnoid hemorrhage by reducing delayed cerebral ischemia from vasospasm. It is a neuroselective calcium channel blocker. Nifedipine and verapamil are not used for this indication. The 21-day duration covers the peak vasospasm window (days 3-14).
Reference: Bailey and Love's Short Practice of Surgery, 27th ed.
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