Exam 2 - important numbers Flashcards

1
Q

E1/2t and clearnece of thiopental and methohexitol

A
  • E1/2t and clearnace d/t hepatic metabolism
  • Thiopentoal
    • E1/2 = 11.6 hours
    • Clearnace = 3.4 ml/kg/min
  • Methohexitol
    • E1/2 = 3.9 hours
    • Clearnace = 10.9 ml/kg/min
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2
Q

% nonionized at 7.4 for thiopental and methohexatol

A

Thiopentol = 61%

Methohexatol = 76%

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3
Q

Relative dosages of methohexatol and thiopental

A

Thiopental Dose

  1. IV: 3-5mg/kg
  2. Elderly = Decrease
  3. Peds IV: 5-6 mg/kg
  4. Infants: 7-8 mg/kg

Methohexatol

  1. IV: 1-2 mg/kg
  2. Peds Rectal: 20-30 mg/kg
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4
Q
  1. pKA = 7.9
  2. % NON-ionized at physoplogic pH = 23%
A

Morphine

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5
Q

pKA = 8.5

% NON-ionized at physoplogic pH = 7%

A

Meperedine (Demerol)

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6
Q

pKA = 8.4

% NON-ionized at physoplogic pH = 8.5%%

A

Fentanyl

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7
Q

pKA = 8.0

% NON-ionized at physoplogic pH = 20%

A

Sufentanil

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8
Q

pKA = 6.5

% NON-ionized at physoplogic pH = 89%

A

Alfentanil

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9
Q

pKA = 7.3

% NON-ionized at physoplogic pH = 58%

A

Remifentanil

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10
Q

Protein binding = 35%

A

Morphine

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11
Q

Protein binding = 70%

A

Meperidine

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12
Q

Protein binding = 84%

A

Fentanyl

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13
Q

Protein binding = 93%

A

Sufentanil

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14
Q

Protein binding = 92%

A

Alfentanil

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15
Q

Protein binding = 66-93%

A

Remifentanil

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16
Q

E1/2t = 3-5 hours

A

Meperedine (demerol)

17
Q

E1/2t = 0.17- 0.33 hours

A

Remifentanil

18
Q

E1/2t = 1.4 - 1.5 hours

A

Alfentanil

19
Q

E1/2t = 2.2-4.6 hours

A

Sufentanil

20
Q

E1/2t = 3.1 - 6.6 hours

A

Fentanyl

21
Q

E1/2t = 1.7-3.3 hours

A

Morphine

22
Q

Dosing of fentanyl

A
  1. Wide ranges: 1-20 mcg/kg for pain and to blunt circulatory responses to DVL, or a chnage in circulatory stimulation
  2. Lozenges: 5-20mcg/kg; 45 minutes prior to inducton
  3. Transdermal Patch: 75-100 mcg/hour; peaks at 18-24 hours
23
Q

Sufentanil potency

A

10x fentanyl and 1000x morphine which parralles sufentanil’s greater affinity for opioid receptors compared to fentanyl

24
Q

Relative starting BOLUS doses of

  1. Fentanyl
  2. Remifentanil
  3. Alfentanil
  4. Sufentanil
A
  1. Fentanyl = 1-3 mcg/kg
  2. Remifentanil = 1-2 mcg/kg (same as fentanyl)
  3. Alfentanil = 10-20 mcg/kg (5x fentanyl)
  4. Sufentanil = 0.1-0.3 mcg/kg (1/10 fentanyl)
25
Q

Starting INFUSION doses of:

  1. Fentanyl
  2. Remifentanil
  3. Alfentanil
  4. Sufentanil
A
  1. Fentanyl = 0.01-0.05 mcg/kg/min
  2. Remifentanil = 0.05-0.25 mcg/kg/min (start at 5)
  3. Alfentanil = 0.25 - 0.75 mcg/kg/min (5x upper fent)
  4. Sufentanil = 0.0015 - 0.01 mcg/kg/min (lil > 1/10)
26
Q

Potency of opiods from lowest to higest

A
  1. Meperedine (Demerol) (1/10)
  2. Morphine
  3. Hydropmorone (Dilaudid) (5x)
  4. Alfentanil (10-20x morphine)(1/5 fentanyl)
  5. Fentanyl (100x)
  6. Remifentanil (100x)
  7. Sufentanil (1000x morphine)(10x fentanyl)