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