Induction Meds: Opioids Agonist - Remifentanil Flashcards

1
Q

What receptor affinity does Remifentanil have?
How potent is it?

A

μ opioid agonist that is equipotent to fentanyl

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2
Q

What is Remifentanil’s structure and why is it important?

A

Ester Structure = hydrolyzed by plasma & tissue esterases.

  • Rapid onset & recovery
  • rapid titratable effect
  • No accumulation
  • rapid recovery when discontinued

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3
Q

What drug was said to be a great choice for carotid procedures in lecture?

A

Remifentanil

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4
Q

What is the clearance of Remfentanil?

A

3-L/min
(8x faster than Alfentanil)

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5
Q

What is the induction dose of Remifentanil?

A

0.5 to 1 µg/kg IV over 30-60 seconds

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6
Q

What is the maintenance dosing of Remifentanil?

A
  • 0.005 - 2 μg/kg/min IV

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7
Q

What is the peak effect of Remifentanil?

A

30 - 60 seconds

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8
Q

Where is Remifentanil excreted?

A

kidneys

(unchanged by renal or hepatic disease)

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9
Q

What is the elimination half-time of Remifentanil?

A

6.3 minutes

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10
Q

What do you need to give before stopping Remifentanil?

A

give longer-acting opioid

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11
Q

What use is not recommended for Remifentanil?

A

spinal or epidural use

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12
Q

What are the side effects of Remifentanil?

A
  • Seizure-like activity
  • N/V
  • Depression of ventilation
  • Decreased BP and HR
  • Hyperalgesia d/t
    -Previous acute exposure to large opioid doses
    -Tolerance

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