Save
Busy. Please wait.
or

show password
Forgot Password?

Don't have an account?  Sign up 
or

Username is available taken
show password

why


Make sure to remember your password. If you forget it there is no way for StudyStack to send you a reset link. You would need to create a new account.
We do not share your email address with others. It is only used to allow you to reset your password. For details read our Privacy Policy and Terms of Service.


Already a StudyStack user? Log In

Reset Password
Enter the associated with your account, and we'll email you a link to reset your password.
focusNode
Didn't know it?
click below
 
Knew it?
click below
Don't know
Remaining cards (0)
Know
0:00
share
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.

  Normal Size     Small Size show me how

Anes. Pharm I Test 2

neuraxial opioids

QuestionAnswer
Describe anatomically how a CRNA would give an epidural neuraxial opioid dose? Needle would go through the ligamentum flavum but not through the drug mater; it is a theoretical space
Describe anatomically how a CRNA would give a spinal neuraxial opioid dose? Needle would go though the dura mater and into the subarachnoid space; you would know you have reach subarachnoid space r/t aspiration of CSF
Which receptors are present in high concentrations in the dorsal horn of the spinal cord? mu, kappa, and delta
Which are the main receptors present in the substantial gelatinosa? mu
The epidural dose should be _____ the subarachnoid dose 5x - 10x
What is the epidural dose of morphine? The spinal dose? epidural: up to 5 mg; spinal: 0.25 - 1 mg
Neuraxial analgesia is specific for ______ pain rather than _______ pain visceral; somatic
True or false: neuraxial opioid analgesia does NOT include a sympathetic denervation, skeletal muscle weakness, or loss of perception of pressure True!
If you are going to give morphine in the epidural space or subarachnoid space, you must ensure that it is what? preservative free
What is the mechanism of action of opioids placed in the epidural space? they diffuse across the dura to affect mu receptors on the spinal cord and are absorbed systemically to produce effects like IV opioids
The higher the lipid solubility of an opioid given epidurally, the _____ absorption systemically more
Why is morphine typically the drug of choice for epidural administration? lower lipid solubility means slower onset, but longer duration
The more lipid soluble, the _______ the diffusion into the CSF faster
When does epidural fentanyl reach peak CSF concentration? 20 minutes after epidural administration
When does epidural Sufentanil reach peak CSF concentration? 6 minutes after epidural administration
When does epidural morphine reach peak CSF concentration? 1 - 4 hours after epidural administration
What percentage of epidural dose of morphine enters the CSF? only 3%
When does fentanyl reach peak blood concentration after epidural administration? 5 - 10 minutes
When does sufentanil reach peak blood concentration after epidural ministration? < 5 minutes
When does morphine reach peak blood concentration after epidural administration? 10 - 15 minutes
How can you decrease vascular absorption of epidural opioid? by injecting epinephrine into the epidural space along with the opioid; vasoconstriction = less absorbed into vasculature
If epinephrine is added to the morphine solution injected into the subarachnoid space, what happens to the analgesic effect? it is enhanced compared with the injection of morphine alone because it stays there longer and is not taken up into the vasculature as readily r/t vasoconstriction
What is the dose and duration of epidural fentanyl? 50 - 100 mcg; duration: 1 - 3 hours
What is the dose and duration of epidural morphine? 2 - 5 mg; duration: 4 - 24 hours
___________ affects the degree of cephalad movement of opioids in the CSF lipid solubility (higher lipid solubility limits movement)
True of false: body position accelerates cephalad movement of opioids in CSF False! coughing or straining can accelerate movement
Are side effects of neuraxial opioids due to the presence of them in the CSF or in systemic circulation? either in CSF or systemic circulation
What are the four classic side effects of neuraxial opioids? pruritis, N/V, urinary retention, depression of ventilation
What can occur 2 - 5 days post epidural administration of morphine? reactivation of herpes virus; r/t cephalad movement of opioid and interaction of trigeminal nucleus
Created by: Mary Beth
 

 



Voices

Use these flashcards to help memorize information. Look at the large card and try to recall what is on the other side. Then click the card to flip it. If you knew the answer, click the green Know box. Otherwise, click the red Don't know box.

When you've placed seven or more cards in the Don't know box, click "retry" to try those cards again.

If you've accidentally put the card in the wrong box, just click on the card to take it out of the box.

You can also use your keyboard to move the cards as follows:

If you are logged in to your account, this website will remember which cards you know and don't know so that they are in the same box the next time you log in.

When you need a break, try one of the other activities listed below the flashcards like Matching, Snowman, or Hungry Bug. Although it may feel like you're playing a game, your brain is still making more connections with the information to help you out.

To see how well you know the information, try the Quiz or Test activity.

Pass complete!

"Know" box contains:
Time elapsed:
Retries:
restart all cards