Narcotics - Sufentanil Flashcards

1
Q

What is the typical dose range of Sufentanil for analgesia when administered intravenously?

A. 0.05-0.2 mcg/kg

B. 0.1-0.4 mcg/kg

C. 0.5-1.0 mcg/kg

D. 1.0-2.0 mcg/kg

A

B. 0.1-0.4 mcg/kg

Castillo TxWes:
Analgesia: 0.1 to 0.4 µg/kg IV
Induction: 18.9 µg/kg IV
Intraop: 0.3 to 1 µg/kg IV
Infusion: 0.5 to 1 µg/kg/hr IV

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2
Q

What is the recommended dose range for Sufentanil when used for induction/ infusion via intravenous administration? (Select 2)

A. 0.1-0.2 mcg/kg IV

B. 0.2-0.5 mcg/kg/hr for infusion

C. 0.5-1 mcg/kg IV

D. 1.0-1.5 mcg/kg/hr for infusion

A

C. 0.5-1 mcg/kg IV
B. 0.2-0.5 mcg/kg/hr for infusion

Induction/infusion dose:
0.5-1 mcg/kg IV or
0.2-0.5 mcg/kg/hr for infusion

Castillo TxWes:
Analgesia: 0.1 to 0.4 µg/kg IV
Induction: 18.9 µg/kg IV
Intraop: 0.3 to 1 µg/kg IV
Infusion: 0.5 to 1 µg/kg/hr IV

Tx Wes Reference:
intraop: 0.3-1 mcg/g
infusion: 0.5-1 mcg/kg/hr

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3
Q

When used for labor analgesia, what is the intrathecal dose range of Sufentanil?

A. 1-3 mcg

B. 2.5-7.5 mcg

C. 10-15 mcg

D. 15-20 mcg

A

B. 2.5-7.5 mcg

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4
Q

What is the reconstitution concentration of Sufentanil when 250 mcg is dissolved in 45 mL of normal saline (NS)?

A. 2.5 mcg/mL

B. 5 mcg/mL

C. 10 mcg/mL

D. 20 mcg/mL

A

B. 5 mcg/mL

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5
Q

What is the typical onset time for Sufentanil after administration?

A. 1 minute

B. 30 seconds

C. 1-2 minutes

D. 4 minutes

A

B. 30 seconds

Tx Wes Reference:
30-60 sec

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5
Q

Which of the following best describes the primary mechanism of action of Sufentanil?

A. Inhibition of serotonin reuptake

B. Blockade of NMDA receptors

C. Suppression of pain through primary action on mu1-opioid receptors

D. Enhancement of GABAergic activity

A

C. Suppression of pain through primary action on mu1-opioid receptors, then kappa and delta opioid-Rs.

Directly inhibit ascending nociceptive presynaptic transmission of excitatory NTs, and activation of descending inhibitory pain pathway.

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6
Q

When does Sufentanil typically reach its peak effect?

A. 1 minute

B. 2 minutes

C. 3 minutes

D. 4 minutes

A

D. 4 minutes

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7
Q

What is the approximate duration of action for Sufentanil?

A. 5 minutes

B. 10 minutes

C. 15 minutes

D. 20 minutes

A

D. 20 minutes

Tx Wes Reference:
1-1.5 hr

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8
Q

What is the elimination half-life of Sufentanil?

A. 1-2 hours

B. 2-4 hours

C. 4-6 hours

D. 6-8 hours

A

B. 2-4 hours

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9
Q

How is Sufentanil metabolized in the body?

A. Primarily by renal excretion

B. Through alpha1-acid glycoprotein binding with 60% lung first-pass before CYP metabolism (N-dealkylation and O-demethylation)

C. By conjugation in the liver

D. By plasma esterases

A

B. Through alpha1-acid glycoprotein binding with 60% lung first-pass before CYP metabolism (N-dealkylation and O-demethylation)

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10
Q

Which of the following describes the primary routes of elimination for Sufentanil?

A. Urine and breath

B. Fecal and renal

C. Bile and saliva

D. Sweat and feces

A

B. Fecal and renal

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11
Q

Sufentanil is noted for being:

A. 10 times less potent than fentanyl

B. Very cardiovascularly unstable

C. 10 times more potent than fentanyl

D. Less potent than morphine

A

C. 10 times more potent than fentanyl

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12
Q

For which type of cases is Sufentanil particularly suited?

A. Pediatric surgeries

B. Outpatient procedures

C. OB epidural cases, spine surgeries, sicker and older patients. very CV stable

D. Short, minimally invasive procedures

A

C. OB epidural cases, spine surgeries, sicker and older patients. very CV stable

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13
Q

What is a key precaution when using Sufentanil before a surgical procedure?

A. Administer 30 minutes before the case

B. Stop administration 45 minutes before the case to ensure emergence

C. Administer continuously throughout the procedure

D. Increase dosage 45 minutes before the case

A

B. Stop administration 45 minutes before the case to ensure emergence

Precautions: Stop 45 minutes before case to ensure emergence; go down by 75% on MAC; caution with chronic renal failure

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14
Q

How should the MAC (Minimum Alveolar Concentration) be adjusted when using Sufentanil?

A. Increase by 50%

B. No adjustment needed

C. Decrease by 25%

D. Decrease by 75%

A

D. Decrease by 75%

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15
Q

Which condition requires caution when using Sufentanil?

A. Acute liver failure

B. Chronic renal failure

C. Hypertension

D. Hyperglycemia

A

B. Chronic renal failure

16
Q

Sufentanil can lead to which cardiovascular effect? Select 2

A. Increased heart rate

B. Decreased cardiac output

C. Bradycardia

D. Increased systemic vascular resistance

A

B. Decreased cardiac output
C. Bradycardia

17
Q

How does Sufentanil impact cerebral physiology?

A. Increases cerebral metabolic rate and blood flow

B. Decreases CMRO2 and CBF

C. Enhances oxygenation in the brain

D. Increases intracranial pressure

A

B. Decreases CMRO2 and CBF

17
Q

Which of the following is a common side effect of Sufentanil?

A. Hyperventilation

B. Chest wall rigidity/skeletal muscle rigidity

C. Tachycardia

D. Increased cardiac output

A

B. Chest wall rigidity/skeletal muscle rigidity

18
Q

Which of the following side effects is associated with Sufentanil and affects ventilation?

A. Increased respiratory rate

B. Depression of ventilation

C. Hypercapnia

D. Respiratory alkalosis

A

B. Depression of ventilation