The lockout interval (LOI) is a necessary safeguard to prevent patients from taking an additional dose before appreciating the effect of the preceding dose.
The refractory period limits the potential of the patient administering an inadvertent overdose due to the "stacking" of opioid doses.
The volume of distribution of the opioids in the plasma is weight related resulting in an appropriate blood level of the opioid.
Loading Dosing Examples: PCA (Maintenance) Dose The PCA dose of opioid is the amount of drug the PCA pump will deliver when the demand button is pressed.
Patient weight is a useful on which to base the PCA dose, even though the correlation between analgesic requirement and weight is poor.
The volume of distribution of a drug is often weight-related and thus a useful guide to prevent over-or under-dosing.
The size of the maintenance (PCA) dose is the primary determinant of the effectiveness of PCA.
Therefore, titration of the maintenance (PCA) dose, based on objective caregiver assessment of pain, is the cornerstone of PCA therapy.
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Common Four-hour Limits Examples: The four-hour limit ranges from 0 to 30 mls of the opioid solution selected.The default limit four-hour limit is 30 mls of the solution, so the concentration of the selected agent will determine the mcg or mg amount of opioid.
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