Narcotics - Alfentanil Flashcards
Sufentanil (1000x)>
Fentanyl=Remifentanil (100x)>
Alfentanil (20x)>
Dilaudid (5x)>
Morphine
Which dose range is typically used for analgesia with Alfentanil?
A. 100-200 mcg IV
B. 250-500 mcg IV
C. 500-1000 mcg IV
D. 1000-1500 mcg IV
B. 250-500 mcg IV
What is the concentration of Alfentanil used for intravenous administration?
A. 50 mcg/mL
B. 100 mcg/mL
C. 250 mcg/mL
D. 500 mcg/mL
D. 500 mcg/mL
What is the onset time for Alfentanil?
A. 0.5 minutes
B. 1.4 minutes
C. 3 minutes
D. 5 minutes
B. 1.4 minutes
(greater than fent and sufent) d/t Pka (more non-ionized)
How does Alfentanil suppress pain according to its MOA?
A. By enhancing ascending nociceptive transmission
B. By inhibiting descending excitatory pain pathways
C. By inhibiting ascending nociceptive presynaptic transmission of excitatory neurotransmitters and activating descending inhibitory pain pathway
D. By increasing the release of excitatory neurotransmitters
C. By inhibiting ascending nociceptive presynaptic transmission excitatory neurotransmitters and activating descending inhibitory pain pathway
What is the primary mechanism of action (MOA) of Alfentanil?
A. NMDA receptor antagonism
B. GABAA receptor agonism
C. Opioid receptor agonism (mu1, kappa, delta)
D. Alpha-2 adrenergic receptor stimulation
C. Opioid receptor agonism (mu1, kappa, delta)
How does the onset time of Alfentanil compare to that of Fentanyl and Sufentanil?
A. Faster than Fentanyl and Sufentanil
B. Slower than Fentanyl and Sufentanil
C. The same as Fentanyl and Sufentanil
D. Only faster than Fentanyl
B. Slower than Fentanyl and Sufentanil
What is the duration of action for Alfentanil?
A. 5-10 minutes
B. 10-15 minutes
C. 15 minutes
D. 30 minutes
C. 15 minutes
What is the half-life of Alfentanil?
A. 30 minutes
B. 60 minutes
C. 90 minutes
D. 2 hours
B. 60 minutes
How is Alfentanil primarily metabolized in the body?
A. By renal excretion
B. Through hydrolysis in the plasma
C. By CYP3A4 into noralfentanil (inactive)
D. By glucuronidation in the liver
C. By CYP3A4 into noralfentanil (inactive)
What percentage of the initial Alfentanil dose undergoes first-pass uptake into the lungs for metabolism?
A. 25%
B. 50%
C. 75%
D. 90%
C. 75%
via alpha1-acid glycoprotein
How is Alfentanil primarily eliminated from the body?
A. Hepatic metabolism
B. Biliary excretion
C. Renal excretion
D. Pulmonary excretion
C. Renal excretion
Compared to Fentanyl, what is the relative potency of Alfentanil?
A. 1/10th potency
B. 1/5th potency
C. Equal potency
D. 2 times the potency
B. 1/5th potency
For which type of patient is Alfentanil especially used due to its pharmacokinetic properties?
A. Pediatric patients
B. Patients with liver disease
C. Renal patients
D. Elderly patients
C. Renal patients
What are the primary clinical uses of Alfentanil?
A. Long-term pain management and sedation
B. Short procedures and induction to blunt SNS response to laryng/intubation
C. Chronic pain management and postoperative care
D. Regional anesthesia and analgesia
B. Short procedures (rapid on/off) and induction to blunt SNS response to laryng/intubation
Which condition is a contraindication for the use of Alfentanil?
A. Acute dystonia in Parkinson’s disease
B. Chronic obstructive pulmonary disease (COPD)
C. Diabetes mellitus
D. Hypertension
A. Acute dystonia in Parkinson’s disease
Which drug interaction is a contraindication for Alfentanil use?
A. Erythromycin
B. Ibuprofen
C. Acetaminophen
D. Diazepam
A. Erythromycin
Which condition may prolong the elimination half-life (E½) of Alfentanil?
A. Renal failure
B. Cirrhosis and elderly
C. Diabetes mellitus
D. Hyperthyroidism
Answer: B. Cirrhosis and elderly
What effect does Alfentanil have on MAC (Minimum Alveolar Concentration)?
A. Increases MAC by 70%
B. Decreases MAC by 70%
C. Has no effect on MAC
D. Increases MAC by 30%
B. Decreases MAC by 70%
Which is a unique respiratory effect of Alfentanil compared to other opioids?
A. It has no effect on ventilation.
B. It causes the least respiratory depression.
C. It is the only opioid known to cause apnea.
D. It causes significant bronchodilation.
C. It is the only opioid known to cause apnea.
What precaution should be taken when using Alfentanil in patients with cerebral lesions?
A. Avoid using Alfentanil as it may increase intracranial pressure (ICP).
B. Alfentanil is safe for use in these patients with no precautions needed.
C. Increase the dose to counteract the effects on ICP.
D. Use a lower dose to minimize effects on ICP.
A. Avoid using Alfentanil as it may increase intracranial pressure (ICP).
Which of the following conditions requires caution when administering Alfentanil?
A. Acute asthma exacerbation
B. Renal failure
C. Hyperglycemia
D. Hypertension
B. Renal failure
What are some common side effects of Alfentanil?
A. Hyperglycemia, insomnia, tachycardia
B. Depression of ventilation (and laryngospams), bradycardia, hypotension, nausea, and vomiting
C. Increased heart rate, hypertension, and dry mouth
D. Seizures, hypertension, and rash
B. Depression of ventilation (and laryngospams), bradycardia, hypotension, nausea, and vomiting
How does Alfentanil affect the baroreceptor reflex and carotid sinus?
A. It enhances their reflexes.
B. It has no effect on the baroreceptor reflex and carotid sinus.
C. It depresses the baroreceptor reflex and carotid sinus activity.
D. It stimulates the baroreceptor reflex and carotid sinus.
C. It depresses the baroreceptor reflex and carotid sinus activity.
Which side effects are associated with Alfentanil? Select 2
A. Diarrhea
B. Constipation
C. Itching
D. Nausea without vomiting
B. Constipation
C. Itching
