The patient with an arteriovenous malformation (AVM) is at risk for intracranial hemorrhage with abrupt increases in intracranial pressure, such as with coughing. However, medications that raise the blood pressure should also be avoided. Benzonatate, or Tessalon Perles, should be ordered to help prevent coughing without raising the blood pressure. Guaifenesin is an expectorant, not an antitussive, and should be avoided. Dextromethorphan is contraindicated in patients taking MAOIs. Ibuprofen with pseudoephedrine will raise the patient’s blood pressure and should be avoided.