Narcotics - Remifentanil Flashcards
What is the typical induction dose of Remifentanil?
A. 0.1-0.2 mcg/kg
B. 0.5-1 mcg/kg
C. 1-2 mcg/kg
D. 2-4 mcg/kg
B. 0.5-1 mcg/kg
TxWes
Induction
0.5 to 1 µg/kg IV over 30-60 seconds
Maintenance
0.25 to 1 µg/kg IV or 0.005 to 2 µg/kg/min IV
What is the range for the General Anesthesia (GA) infusion dose of Remifentanil?
A. 0.01-1 mcg/kg/min
B. 0.02-2 mcg/kg/min
C. 0.1-5 mcg/kg/min
D. 1-10 mcg/kg/min
B. 0.02-2 mcg/kg/min
(turn off 6 mins before breathing and give longer acting)
TxWes
Induction
0.5 to 1 µg/kg IV over 30-60 seconds
Maintenance
0.25 to 1 µg/kg IV or 0.005 to 2 µg/kg/min IV
How should Remifentanil be administered in relation to the end of the surgical procedure?
A. Start the infusion at the end of the procedure.
B. Turn off the infusion 6 minutes before the end of the procedure and switch to a longer-acting anesthetic.
C. Continue the infusion until the end of the procedure.
D. Administer a bolus dose at the end of the procedure.
B. Turn off the infusion 6 minutes before the end of the procedure and switch to a longer-acting anesthetic.
What is the reconstitution concentration of Remifentanil when prepared as 2 mg in 40 mL?
A. 10 mcg/mL
B. 20 mcg/mL
C. 25 mcg/mL
D. 50 mcg/mL
D. 50 mcg/mL
What is the primary mechanism of action (MOA) of Remifentanil?
A. Inhibition of serotonin reuptake
B. Suppression of pain through primary action on mu1 receptors, then kappa and delta opioid receptors
C. Activation of NMDA receptors
D. Antagonism of GABA-A receptors
B. Suppression of pain through primary action on mu1 receptors, then kappa and delta opioid receptors
How quickly does Remifentanil typically reach its peak effect after administration?
A. 0.5 minutes
B. 1 minute
C. 1.1 minutes
D. 3 minutes
C. 1.1 minutes
What is the duration of action for Remifentanil?
A. 1-3 minutes
B. 3-5 minutes
C. 5-10 minutes
D. 10-20 minutes
C. 5-10 minutes
What is the elimination half-life (½ life) of Remifentanil?
A. 2 minutes
B. 6 minutes
C. 15 minutes
D. 30 minutes
B. 6 minutes
What percentage of Remifentanil undergoes first-pass uptake into the lungs for metabolism?
A. 25%
B. 50%
C. 75%
D. 90%
C. 75%
How is Remifentanil metabolized in the body?
A. By hepatic metabolism via CYP450 enzymes
B. By renal excretion
C. By hydrolysis via plasma and tissue esterases
D. By conjugation in the liver
C. By hydrolysis via plasma and tissue esterases
lack of accumulation
How is Remifentanil primarily eliminated from the body?
A. Hepatic metabolism
B. Renal excretion
C. Pulmonary metabolism
D. Gastrointestinal excretion
B. Renal excretion
(unchanged by renal/liver disease)
In what way is Remifentanil similar to fentanyl in terms of potency?
A. It has half the potency of fentanyl.
B. It has the same potency as fentanyl.
C. It is twice as potent as fentanyl.
D. It is ten times less potent than fentanyl.
B. Ester; It has the same potency as fentanyl.
What is a key reason Remifentanil is used in
Total Intravenous Anesthesia (TIVA) with propofol (no gas craniotomy)
doesn’t interfere with MEPs
Total Intravenous Anesthesia (TIVA) with propofol (no gas craniotomy)
doesn’t interfere with MEPs
For which type of procedure is Remifentanil particularly useful due to its properties?
A. Long-term sedation
B. Carotid endarterectomy
C. Chronic pain management
D. Postoperative analgesia
B. Carotid endarterectomy
Why is Remifentanil contraindicated for intrathecal administration?
A. It causes severe hypotension.
B. It forms glycine, which is toxic to nerves.
C. It leads to significant respiratory depression.
D. It causes excessive sedation.
B. It forms glycine, which is toxic to nerves.
