LESI LESI Pharmacology 2

Question 1

How long does the anti-inflammatory effect of a single epidural corticosteroid injection typically last?

Accepted Answer

1-3 weeks

Answer

The clinical anti-inflammatory effect of epidural corticosteroids generally lasts 1-3 weeks, though symptom relief may persist longer due to interruption of the pain cycle.

Question 2

What is the FDA's current regulatory status of corticosteroid use for epidural injection?

Accepted Answer

Off-label use — not approved for epidural administration

Answer

No corticosteroid is currently FDA-approved for epidural administration; their use via this route is off-label, and the FDA requires a warning label about this.

Question 3

Systemic absorption of epidural corticosteroids can suppress the hypothalamic-pituitary-adrenal (HPA) axis for approximately how long?

Accepted Answer

1-3 weeks

Answer

Epidural corticosteroids are absorbed systemically and can suppress the HPA axis for approximately 1-3 weeks, which is clinically relevant in diabetic or immunocompromised patients.

Question 4

Which contrast agent is used to confirm epidural needle placement under fluoroscopy before steroid injection?

Accepted Answer

Non-ionic iodinated contrast (e.g., iohexol)

Answer

Non-ionic iodinated contrast agents such as iohexol (Omnipaque) are used epidurally because they are non-neurotoxic and allow real-time fluoroscopic confirmation of spread pattern.

Question 5

The maximum recommended number of lumbar ESI injections in a 12-month period per most clinical guidelines is:

Accepted Answer

3-4 injections

Answer

Most pain management societies recommend limiting lumbar ESIs to 3-4 injections per year to minimize cumulative steroid side effects including osteoporosis and HPA axis suppression.

LESI - Lumbar Epidural Steroid Injection Practice Test

LESI - Lumbar Epidural Steroid Injection Practice Test

LESI LESI Pharmacology 2