Opioid Agents Flashcards
(158 cards)
1
Q
What is the typical IV bolus dose of fentanyl for analgesia during anesthesia?
A
25–50 mcg
2
Q
What is the approximate onset of action of fentanyl when given intravenously?
A
30–60 seconds
3
Q
What is the typical duration of action of IV fentanyl after a single dose?
A
30–60 minutes
4
Q
What is the mechanism of action of fentanyl?
A
Mu-opioid receptor agonist
5
Q
Which of the following is a notable side effect of fentanyl?
A
Chest wall rigidity
6
Q
In which of the following clinical scenarios is fentanyl most appropriately used?
A
Adjunct to general anesthesia for intraoperative analgesia
7
Q
Which of the following best describes fentanyl’s potency compared to morphine?
A
100 times more potent
8
Q
Is Fentanyl a short-acting synthetic opioid?
A
True
9
Q
Does Fentanyl provide both analgesia and amnesia?
A
No (It provides analgesia, not amnesia)
10
Q
Does Fentanyl cause bradycardia and respiratory depression?
A
Yes
11
Q
Does Fentanyl have a slower onset of action than morphine?
A
No, it is faster
12
Q
Is Fentanyl commonly used in rapid sequence intubation protocols?
A
Yes
13
Q
Is Fentanyl associated with histamine release and hypotension?
A
No (Unlike morphine, it causes minimal histamine release)
14
Q
Can the duration of fentanyl’s effect be prolonged with repeated dosing?
A
Yes
15
Q
What is a typical IV dose range of fentanyl for analgesia in adult patients?
A
25-50 mcg; however 50–100 mcg IV bolus is also common
16
Q
What is the onset time of fentanyl after IV administration?
A
Within 30–60 seconds
17
Q
What is the duration of action of a single IV dose of fentanyl?
A
Approximately 30–60 minutes
18
Q
What receptor does fentanyl primarily act on?
A
Mu-opioid receptor (μ-opioid receptor)
19
Q
List two common side effects of fentanyl.
A
- Respiratory depression
- Bradycardia
- Chest wall rigidity
20
Q
Why might fentanyl be preferred over morphine in a hemodynamically unstable patient?
A
Because it has minimal histamine release and less hypotension
21
Q
When should fentanyl be used cautiously?
A
In patients with compromised respiratory function or those on other CNS depressants
22
Q
What complication can occur if fentanyl is administered too rapidly in high doses?
A
Chest wall rigidity, which can impair ventilation
23
Q
What is the typical IV dose of morphine for adult pain management?
A
2–5 mg
24
Q
What is the approximate onset of action of morphine when administered intravenously?
A
5–10 minutes
25
What is the typical duration of action for IV morphine?
2–4 hours
26
Morphine primarily acts on which receptor type?
Mu-opioid
27
Which of the following is a common side effect of morphine?
Constipation
28
Which of the following makes morphine less desirable in patients with hemodynamic instability?
Histamine release
29
Which clinical scenario best describes appropriate use of morphine?
Pain management post major abdominal surgery
30
Does Morphine have a slower onset than fentanyl?
Yes
31
Does Morphine cause any histamine release?
Yes
32
Is Constipation a common side effect of morphine?
Yes
33
Does Morphine cross the blood-brain barrier slower than fentanyl?
Yes
34
Is Morphine safe for use in all renal-impaired patients?
No (Active metabolites can accumulate)
35
Is Morphine a full agonist at mu-opioid receptors?
Yes
36
Respiratory depression is a rare side effect of morphine?
No it is common
37
What is a typical IV dose of morphine for moderate to severe pain?
2–5 mg IV every 4 hours as needed
38
What is the onset time of IV morphine?
Approximately 5–10 minutes
39
How long does a single dose of IV morphine typically last?
2–4 hours
40
What is the mechanism of action of morphine?
Morphine is a full mu-opioid receptor agonist that inhibits pain signaling pathways
41
List three common side effects of morphine.
* Nausea
* Respiratory depression
* Constipation
42
What major cardiovascular effect can be caused by histamine release with morphine use?
Hypotension
43
Why should morphine be used with caution in patients with renal impairment?
Its active metabolite (morphine-6-glucuronide) accumulates and may cause prolonged sedation or respiratory depression
44
When is morphine preferred over fentanyl in clinical use?
For longer-lasting pain relief in settings where slower onset and longer duration are desired
45
How much more potent is Sufentanil compared to fentanyl?
50–100 times
46
What is the typical IV bolus dose of Sufentanil for adult anesthesia induction?
0.05–0.2 mcg/kg
47
What is the approximate onset of action of Sufentanil?
30–60 seconds
48
What is the typical duration of action of a single IV dose of Sufentanil?
20–45 minutes
49
What is the primary mechanism of action of Sufentanil?
Mu-opioid receptor agonism
50
In which clinical setting is Sufentanil most commonly used?
Intraoperative analgesia in cardiac or major surgeries
51
What is a major side effect of Sufentanil that must be monitored closely?
Respiratory depression
52
Is Sufentanil more lipid-soluble than fentanyl?
Yes
53
Does Sufentanil have a longer duration of action than morphine?
No
54
Does Sufentanil cause histamine release?
No
55
Is respiratory depression caused by Sufentanil dose-dependent?
Yes
56
Can Sufentanil be reversed with naloxone?
Yes
57
Is Sufentanil commonly used in neuraxial anesthesia (e.g., epidural)?
Yes
58
Does Sufentanil provide both analgesia and amnesia?
No (It provides analgesia, not amnesia)
59
What is the usual bolus dose range of Sufentanil for general anesthesia in adults?
0.05-0.2 mcg/kg IV
60
What is the onset time of Sufentanil after IV administration?
Approximately 30–60 seconds
61
How long does a single dose of Sufentanil typically last?
Approximately 20–45 minutes
62
What receptor does Sufentanil act on?
Mu-opioid receptors
63
Name two clinical scenarios where Sufentanil would be an appropriate choice.
* Cardiac surgery
* Epidural analgesia during labor
64
List three common side effects of Sufentanil.
* Respiratory depression
* Bradycardia
* Nausea/vomiting
65
Why might Sufentanil be preferred over fentanyl for certain surgeries?
Greater potency and shorter duration allow for precise titration during major surgeries
66
What is one major risk when Sufentanil is administered in high doses or too rapidly?
Chest wall rigidity or profound respiratory depression
67
What is the typical bolus dose of Remifentanil for induction in general anesthesia?
0.25 mcg/kg
68
What is the recommended maintenance infusion dose of Remifentanil during general anesthesia?
0.05–2 mcg/kg/min
69
What is the typical onset of action of Remifentanil after IV administration?
15–30 seconds
70
How long does the effect of Remifentanil last after discontinuation?
5–10 minutes
71
Which enzyme is primarily responsible for the metabolism of Remifentanil?
Plasma cholinesterases
72
Which clinical scenario best fits the use of Remifentanil?
TIVA (Total Intravenous Anesthesia) requiring rapid offset
73
Which of the following is a major side effect associated with high-dose Remifentanil use?
Chest wall rigidity
74
Does Remifentanil have a rapid onset and ultra-short duration of action?
Yes
75
Does Remifentanil accumulate significantly with prolonged infusions?
No
76
Is Remifentanil suitable for use in patients with hepatic or renal impairment?
Yes
77
Can Remifentanil be administered via intramuscular injection?
No
78
Do the effects of Remifentanil wear off quickly after stopping the infusion?
Yes
79
Does Remifentanil act primarily on delta-opioid receptors?
No (It acts on mu-opioid receptors)
80
Should Remifentanil be used for post-operative pain control due to its short action?
No
81
What is the usual IV bolus dose of Remifentanil?
0.25 mcg/kg
82
What is the typical onset time of Remifentanil?
30–60 seconds
83
How long does Remifentanil’s effect last after discontinuation?
5–10 minutes
84
What is the mechanism of action of Remifentanil?
It is a potent mu-opioid receptor agonist that modulates pain signaling in the CNS.
85
Why is Remifentanil ideal for short surgical procedures?
Because it has a rapid onset and ultra-short duration, allowing tight control over analgesia with quick recovery.
86
What enzyme breaks down Remifentanil in the body?
Plasma esterases (non-specific cholinesterases)
87
List three side effects of Remifentanil.
* Respiratory depression
* Bradycardia
* Chest wall rigidity
88
Why is Remifentanil not used for post-operative pain management?
Because of its rapid clearance and short duration—it wears off quickly and lacks residual analgesia.
89
What is the usual IV dose of Meperidine for moderate pain in adults?
12.5-25mg
90
What is the typical onset of action for IV Meperidine?
1–5 minutes
91
What is the typical duration of analgesia for a single dose of Meperidine?
2–4 hours
92
Which neurotransmitter system is most directly affected by Meperidine’s mechanism of action?
Mu-opioid receptors
93
Which serious side effect is associated with the accumulation of Meperidine’s metabolite, normeperidine?
Seizures
94
In what scenario might Meperidine be preferred over other opioids?
Treatment of rigors/shivering
95
Does Meperidine have both analgesic and local anesthetic properties?
Yes
96
Does Meperidine have a shorter half-life than morphine?
No
97
Is Normeperidine an active metabolite of Meperidine that is neurotoxic?
Yes
98
Should Meperidine be avoided in patients with renal failure?
Yes
99
Is Meperidine a good choice for chronic pain management?
No
100
Can Meperidine cause serotonin syndrome if combined with MAO inhibitors?
Yes
101
Is Meperidine primarily metabolized by the kidneys?
No (Metabolized in the liver, excreted by kidneys)
102
What is the typical IV dose of Meperidine for an adult patient in moderate pain?
12.5-25 mg IV
103
What is the typical onset time of IV Meperidine?
1–5 minutes
104
What is the duration of action of Meperidine?
2–4 hours
105
What receptor does Meperidine primarily act on to produce analgesia?
Mu-opioid receptor
106
What is the name of Meperidine’s neurotoxic metabolite?
Normeperidine
107
List three common side effects of Meperidine.
* Nausea
* Respiratory depression
* Dizziness
108
Why should Meperidine be avoided in patients with renal impairment?
Because normeperidine can accumulate and increase the risk of seizures
109
In what situation is Meperidine especially useful over other opioids?
For the treatment of post-anesthesia shivering or rigors
110
What condition can result from combining Meperidine with MAO inhibitors?
Serotonin syndrome
111
What is the typical IV dose of Hydromorphone for moderate to severe pain in adults?
0.25–0.5 mg
112
What is the onset time for IV Hydromorphone?
5 minutes
113
What is the duration of action for IV Hydromorphone?
3–4 hours
114
Hydromorphone is how many times more potent than morphine?
5–7×
115
Which receptor does Hydromorphone primarily act on to exert its analgesic effects?
Mu-opioid receptor
116
In which of the following scenarios is Hydromorphone most appropriate?
Moderate-to-severe post-operative pain
117
Is Hydromorphone more potent than morphine?
Yes
118
Does Hydromorphone have a slower onset than morphine?
No (It has a faster onset)
119
Is Hydromorphone suitable for use in patients with opioid tolerance?
Yes
120
Does Hydromorphone act primarily on the kappa-opioid receptor?
No (It acts on the mu-opioid receptor)
121
Are common side effects of Hydromorphone include respiratory depression and constipation?
Yes
122
Is Hydromorphone recommended for use in renal impairment?
Yes (It is generally preferred over morphine in renal impairment)
123
Is Hydromorphone contraindicated in patients with a history of opioid addiction?
No (It must be used cautiously, not necessarily contraindicated)
124
What is the typical IV dosage of Hydromorphone for an adult?
0.25–5 mg IV
125
What is the onset time for IV Hydromorphone?
Approximately 5 minutes
126
How long does the analgesic effect of Hydromorphone usually last?
3–4 hours
127
Describe the mechanism of action of Hydromorphone.
It is a potent mu-opioid receptor agonist that inhibits pain transmission in the central nervous system.
128
List three common side effects of Hydromorphone.
* Respiratory depression
* Nausea
* Constipation
129
Why might Hydromorphone be preferred over Morphine in patients with renal impairment?
Hydromorphone produces fewer active metabolites that accumulate in renal dysfunction.
130
In what type of clinical setting is Hydromorphone commonly used?
For the management of moderate to severe acute or chronic pain, especially post-operative pain
131
What is one major risk when using Hydromorphone at high doses or in opioid-naïve patients?
Respiratory depression
132
What is the typical adult IV dose of Naloxone for opioid overdose?
1-4 mcg/kg
133
What is the onset of action for IV Naloxone?
30 seconds to 2 minutes
134
What is the typical duration of action of Naloxone?
1–4 hours
135
Which receptor does Naloxone primarily antagonize?
Mu-opioid
136
Which of the following is a possible effect of Naloxone in opioid-dependent patients?
Acute withdrawal symptoms
137
In which of the following scenarios is Naloxone indicated?
Opioid-induced respiratory depression
138
Is Naloxone effective at reversing benzodiazepine overdose?
No
139
Does Naloxone have a shorter half-life than many opioids?
Yes
140
Does Naloxone bind to mu-opioid receptors and activate them?
No (It is an antagonist, not an agonist)
141
Will Naloxone need to be re-administered if opioid effects outlast it?
Yes
142
Can Naloxone be given intranasally?
Yes
143
Is one dose of Naloxone always sufficient to reverse all opioid overdoses?
No
144
Does Naloxone have known side effects?
Yes
145
What is the standard IV dose range of Naloxone for an adult opioid overdose?
1-4 mcg/kg IV
146
What is the onset time for Naloxone when given IV?
30 seconds to 2 minutes
147
How long does Naloxone typically last in the body?
1 to 4 hours
148
Can Naloxone be given intranasally?
Yes
## Footnote
Naloxone can be administered via the nasal route for opioid overdose reversal.
149
Is one dose of Naloxone always sufficient to reverse all opioid overdoses?
No
## Footnote
Some overdoses may require multiple doses due to the potency of the opioid involved.
150
Does Naloxone have known side effects?
Yes
## Footnote
Side effects may include withdrawal symptoms in opioid-dependent individuals.
151
What is the standard IV dose range of Naloxone for an adult opioid overdose?
1-4 mcg/kg IV
## Footnote
Dosing may vary based on clinical response.
152
What is the onset time for Naloxone when given IV?
30 seconds to 2 minutes
## Footnote
Rapid onset is critical in emergency situations.
153
How long does Naloxone typically last in the body?
1 to 4 hours
## Footnote
Duration of action may be shorter than some opioids.
154
What is the mechanism of action of Naloxone?
It is a competitive antagonist at opioid receptors, especially mu-opioid receptors, blocking the effects of opioids
## Footnote
This mechanism helps to reverse the effects of opioid overdose.
155
List two clinical situations where Naloxone is indicated.
* Opioid overdose with respiratory depression
* Post-operative opioid-induced sedation
## Footnote
Naloxone is used in emergencies and after surgeries to counteract sedation.
156
What may occur if Naloxone is administered to an opioid-dependent patient?
Sudden and severe opioid withdrawal symptoms
## Footnote
Symptoms can include agitation, nausea, vomiting, and tachycardia.
157
What is one possible side effect of Naloxone?
* Hypertension
* Agitation
* Nausea
* Vomiting
* Tachycardia
## Footnote
These side effects may arise especially in opioid-dependent individuals.
158
Why might repeat doses or a continuous infusion of Naloxone be necessary?
Because its duration of action is shorter than many opioids, leading to re-sedation
## Footnote
Continuous monitoring and administration may be required in severe overdoses.
