Demerol,fentanyls,antagonist..
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| What agonist receptors do Meperidine have? | Mu & Kappa
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| Which is the only opioid that causes atropine-like antispasmotic effects? Cause increase HR | Meperidine
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| What is the duration of Mereridine? | 2-4 hours
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| What are the metabolites of Meperidine? | Normeperidine & Meperidinic acid
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| Main route of elimination of Demerol | Urinary
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| Which of the demerol metabolites causes siezure? | Normeperidine
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| Which drug is indicated for labor & delivery, post op shivering? | Meperidine
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| Anti- shivering effect of meperidine is caused by stimulation of what? | Kappa receptors
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| Which opioid is more frequent in causing hypotension and histamine release? | Meperidine
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| HIGH DOSES of Meperidine will cause? | NEGATIVE cardiac inotropic effects plus histamine release... (hypotension)
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| Which opioid more frequently cause biliary spasms? | codeine
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| Which narcotic causes more ventilatory depression? Meperidine or Morphine? | Meperidine
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| Meperidine effect on the pupils will cause... | Mydriasis
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| Morphine effect on the pupils will cause.... | miosis
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| Fentanyl has a ________onset & ________duration...... | rapid/short
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| the effect site equilibration time for Fentanyl is | 6.4 minutes
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| Fentanyl is metabolized by | liver
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| What is metabolites of Fentanyl? | Norfentanyl
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| The elimination half time for Fentanyl is long b/c it reflects the | large Vd
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| the high solubility of Fentanyl reflects is... | high potency & rapid onset
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| Fentanyls short duration is caused by | the redistribution into inactive tissue sites. it undergoes 1st pass lung effect.
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| How is norfentanyl formed? | N-demethylation
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| You should be cautious in using Fentanyl is_____ pts. Why? | Elderly; they have a decreased clearance and decreased hepatic blood flow
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| Duration of Fentanyl longer than 2 hrs will cause the context half-time to be increased and be longer than which analogue of Fentanyl | Sufentanil/sufenta
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| Which opioids cause a decrease in plasma concentration w/ CABG pts? | ALL opioids
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| What FENTANYL doses is adequate for ANALGESIA effects? | 1-2mcg/kg IV
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| What FENTANYL dose is adequate to blunt tachycardia & HTN associated w/ laryngoscopy | 2-20mcg/kg IV
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| What FENTANYL doses is qdequate for surgical anesthesia? | 50-150mcg/kg IV
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| Are these a PRO or CON for Fentanyl?indirect myocardial depression, suppress of stress response & lack of histamine release | PRO/ADVANTAGE
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| Are these a PRO or CON of Fentanyl?doesnt prevent sympathetic response to painful stimuli, possible patient awareness, post-op resp. depression | CON/DISADVANTAGE
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| Bradycardia is more prominent with which opioid? | Fentanyl
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| Seizure activity has been reported with which opioids? | Alfentanyl & fentanyl; there is NO evidence of seizure activity on EEG though
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| Sufentanil and Fentanyl can cause what changes to the ICP? | increased ICP(in head injury pt) by 6-9 mmHg
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| What is the effecti site equilibration for Fentanyl? | 6.4 minutes
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| What is the effect site equilibration for Sufentanil? | 6.2 minutes
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| What is the effect site equilibration for Alfentanil? | 1.4 minutes
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| Which opioid is the ONLY drug that undergoes ester hydrolysis? | Remifentanyl
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| Which opioid is good for long surgeries and has a rapid induction, early emergence & early extubation? | Sufentanil
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| What analogue of fentanyl can be used for outpatients? | Alfentanil
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| Which opioids can be used for retrobubular blocks & larygoscopy? | Remifentanil & Alfentanil
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| Which opioid would you not prefer to give for a sx that is known to have significant postop pain? | Remifentanil
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| Potency/lipid solubility from highest to lowest is as follows: | Sufentanil, Remifentanil, Fentanyl, Alfentanil, Morphine & Mereperidine
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| Onset of action from highest to lowest is as follows: | Alfentanil/Remifentanyl, Sufentanil, Fentanyl, Morphine & Merepidine
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| Fentanyl has a ________onset & ________duration...... | rapid/short
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| the effect site equilibration time for Fentanyl is | 6.4 minutes
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| Fentanyl is metabolized by | liver
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| What is metabolites of Fentanyl? | Norfentanyl
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| The elimination half time for Fentanyl is long b/c it reflects the | large Vd
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| the high solubility of Fentanyl reflects is... | high potency & rapid onset
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| Fentanyls short duration is caused by | the redistribution into inactive tissue sites. it undergoes 1st pass lung effect.
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| How is norfentanyl formed? | N-demethylation
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| You should be cautious in using Fentanyl is_____ pts. Why? | Elderly; they have a decreased clearance and decreased hepatic blood flow
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| Duration of Fentanyl longer than 2 hrs will cause the context half-time to be increased and be longer than which analogue of Fentanyl | Sufentanil/sufenta
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| Which opioids cause a decrease in plasma concentration w/ CABG pts? | ALL opioids
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| What FENTANYL doses is adequate for ANALGESIA effects? | 1-2mcg/kg IV
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| What FENTANYL dose is adequate to blunt tachycardia & HTN associated w/ laryngoscopy | 2-20mcg/kg IV
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| What FENTANYL doses is qdequate for surgical anesthesia? | 50-150mcg/kg IV
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| Are these a PRO or CON for Fentanyl?indirect myocardial depression, suppress of stress response & lack of histamine release | PRO/ADVANTAGE
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| Are these a PRO or CON of Fentanyl?doesnt prevent sympathetic response to painful stimuli, possible patient awareness, post-op resp. depression | CON/DISADVANTAGE
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| Bradycardia is more prominent with which opioid? | Fentanyl
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| Seizure activity has been reported with which opioids? | Alfentanyl & fentanyl; there is NO evidence of seizure activity on EEG though
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| Sufentanil and Fentanyl can cause what changes to the ICP? | increased ICP(in head injury pt) by 6-9 mmHg
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| What is the effecti site equilibration for Fentanyl? | 6.4 minutes
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| What is the effect site equilibration for Sufentanil? | 6.2 minutes
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| What is the effect site equilibration for Alfentanil? | 1.4 minutes
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| Which opioid is the ONLY drug that undergoes ester hydrolysis? | Remifentanyl
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| Which opioid is good for long surgeries and has a rapid induction, early emergence & early extubation? | Sufentanil
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| What analogue of fentanyl can be used for outpatients? | Alfentanil
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| Which opioids can be used for retrobubular blocks & larygoscopy? | Remifentanil & Alfentanil
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| Which opioid would you not prefer to give for a sx that is known to have significant postop pain? | Remifentanil
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| Potency/lipid solubility from highest to lowest is as follows: | Sufentanil, Remifentanil, Fentanyl, Alfentanil, Morphine & Mereperidine
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| Onset of action from highest to lowest is as follows: | Alfentanil/Remifentanyl, Sufentanil, Fentanyl, Morphine & Merepidine
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| What opioid antagonist is helpful to prevent constipation & delayed gastric motility? | Methylnatroxene Bromide Relistor
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| What drug is used for withdrawal symptoms of Opioids? | Clonidine
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| Methylnatrexone Bromide blocks which opioid receptor? | Mu
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| What condition is methylnatrexone bromide is CONTRAINDICATED in? | bowel obstruction
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| Which opioid agonist has an antitussive effect? | Codeine
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| True or False: It is fine to give Codeine IV? | False, Why?
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| True of False: Dilaudid is a derivative of Morphine and is more potent? | True;
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| What happens if you give codeine IV? | significant histamine release & hypotension
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| Which opioid agonist will you give if you want to suppress a cough but not have any analgesic effects | Dextromethorphan
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| What medicine do you want to give to control withdrawals from Opioids? | Methadone
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| What opioid agonist will you give to someone who has mild-moderate pain unrelieved by ASA or acetamenophine? | Darvon
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| What centrally acting analgesic has a low affinity to MU receptors? | Tramadol; Ultram
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| Partial agonist- antagonist binds to what receptors? | Mu,Kappa & Delta
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| What are the ceiling effects for Morphine? | 65%
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| What is the ceiling effect for Sufentanil? | 70-90%
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| What is the ceiling effect for Alfentanil | 70%
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| What is the ceiling effect for Remifentanil | 50-91%
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| What is the ceiling effect for Fentanyl? | 50%
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| Naloxone, Naltrexone, & Nalmefene are examples of________ | Opioid Antagonist
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| Petazocine, Dezocine, Nalbuphine, Buprenorphine & Butophanol are examples of_________ | Opioid Agonist-Antagonist
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| Which antagonist treats opioid depression, itching & overdose? | Naloxone
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| Which antagonist has a longer duration than Naloxone? | Nalmefene
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