Remifentanil Flashcards Preview

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Flashcards in Remifentanil Deck (23)
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1
Q

What is the trade name of Remifentanil?

A

Ultiva

2
Q

What is the formal drug class of Remifentanil?

A

synthetic mu-opioid agonist

piperidine-derived with an ester link

3
Q

What is different about the metabolism of Remifentanil?

A

-ester linkage and the resultant ultra- rapid metabolism of this drug make it unique among the opioids

4
Q

What are the uses of Remifentanil?

A
  • analgesic during GA, in which quick onset and offset of effect is desired
  • used for suppression of transient sympathetic nervous system response to direct laryngoscopy and tracheal intubation
5
Q

How is Remifentanil metabolized?

A
  • undergoes rapid metabolism by nonspecific plasma and tissue esterases
  • metabolized to inactive metabolites excreted by the kidneys
6
Q

Is Remifentanil metabolized by pseudocholinesterases?

A

NO; therefore clearance is not affected by cholinesterase deficiency

7
Q

What is the onset of action of Remifentanil?

A

1 - 3 minutes

8
Q

When is the peak of Remifentanil?

A

1.5 - 2 minutes

9
Q

What is the DOA of Remifentanil?

A

7 - 12 minutes

10
Q

What is the elimination 1/2 life of Remifentanil?

A

10 minutes

11
Q

What is the clearance of Remifentanil?

A

3 - 5 L/min

12
Q

What is the Vd?

A

0.3 - 0.5 L/kg ~25mL in adults

13
Q

Is Remifentanil protein bound?

A

66-93%

14
Q

What is the induction infusion dosage of Remifentanil?

A

0.5 - 1 mcg/kg over 60-90 seconds

15
Q

What is the addnal bolus dose of Remifentanil?

A

0.1 - 1 mcg/kg

16
Q

What is the maintenacne infusion rate of Remifentanil?

A

0.1 -1 mcg/kg/min

17
Q

What is the loading dose of Remifentanil?

A

1 -2 mcg/kg

18
Q

What is the dose of Remifentanil?

A

1 -2 mcg/kg

19
Q

What is the Infusion rate of Remi?

A

0.05 - 0.25 mcg/kg/min

20
Q

What is unique about Remifentanil?

A

chemically r/t fentanyl but has ester linkage

21
Q

What is unique about Remifentanil’s Vd?

A

VERY SMALL Vd, minimal accumulation in tissues, even with infusion

22
Q

What is the potency of Remifentanil similar to?

A

Potency similar to fentanyl; 100 times more potent than morphine

23
Q

What is the clinical significance of Remifentanil?

A
  • used to blunt noxious stimulus

- infusions for interm/long surgeries where rapid recovery is desired such as neurosurgery, O/P surgery