Narcotics: Remifentanil

Question 1

What is the brand name for Remifentanil commonly used in clinical settings?

A) Alfenta
B) Sufenta
C) Ultiva
D) Sublimaze

Answer 1

C) Ultiva

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Question 2

Remifentanil is primarily an agonist at which type of opioid receptor?

A) Delta
B) Kappa
C) Mu
D) Sigma

Answer 2

C) Mu

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Question 3

What is the recommended loading dose range for Remifentanil over 1 minute?

A) 0.125-0.375 mcg/kg
B) 0.5-1 mcg/kg
C) 1-2 mcg/kg
D) 5-10 mcg/kg

Answer 3

B) 0.5-1 mcg/kg

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Question 4

What is the recommended infusion rate for Remifentanil?

A) 0.05-0.1 mcg/kg/min
B) 0.125-0.375 mcg/kg/min
C) 0.5-1 mcg/kg/min
D) 1-2 mcg/kg/min

Answer 4

B) 0.125-0.375 mcg/kg/min

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Question 5

If a patient has been receiving a Remifentanil infusion, it should be stopped ___ minutes before attempting breathing trials.

A) 3
B) 5
C) 6
D) 10

Answer 5

C) 6

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Question 6

Why is Remifentanil considered an ultra-short-acting opioid?

A) It has a very long half-life
B) It is metabolized rapidly by plasma esterases
C) It binds tightly to mu receptors
D) It is excreted slowly by the kidneys

Answer 6

B) It is metabolized rapidly by plasma esterases

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Question 7

Remifentanil is known for causing ___ respiratory depression and may also lead to ___.

A) Slow, tachycardia
B) Quick, bradycardia
C) Delayed, hypertension
D) Moderate, arrhythmia

Answer 7

B) Quick, bradycardia

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Question 8

When using Remifentanil as an infusion (gtt), it can reduce the MAC (Minimum Alveolar Concentration) requirement by up to:

A) 30%
B) 50%
C) 70%
D) 90%

Answer 8

C) 70%

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Question 9

Remifentanil is commonly used in procedures such as:

A) Cardiac bypass surgery
B) Neuro, carotid endarterectomy, eye blocks, and TIVA (Total Intravenous Anesthesia)
C) Obstetric epidurals
D) Routine dental procedures

Answer 9

B) Neuro, carotid endarterectomy, eye blocks, and TIVA

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Question 10

Because of its ultra-short duration, Remifentanil must be paired with another drug for:

A) Induction of anesthesia
B) Intraoperative hemodynamic stability
C) Post-operative pain control
D) Rapid emergence

Answer 10

C) Post-operative pain control

Must cover for post op pain with another drug
Quick on and Quick OFF

duration 6-8 min

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Question 11

One disadvantage of using Remifentanil is that it is:

A) Not suitable for infusion
B) Expensive
C) Ineffective for neurosurgery
D) Unpredictable in duration

Answer 11

B) Expensive

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Question 12

Put it all together

1. Remifentanil is a ___ opioid agonist.
2. The loading dose of Remifentanil is ___ mcg over 1 minute.
3. The recommended infusion rate for Remifentanil is ___ mcg/kg/min.
4. If a patient has been receiving a Remifentanil infusion, it should be stopped ___ minutes before attempting breathing trials.
5. Remifentanil is metabolized by ___, making it independent of organ function.
6. One of the major side effects of Remifentanil is quick ___ depression.
7. Remifentanil can cause ___ as a cardiovascular side effect.
8. Using Remifentanil can lead to up to ___% reduction of MAC.
9. Remifentanil is commonly used for ___, ___ endarterectomy, ___ blocks, and ____.
10. Due to its ___ offset, Remifentanil requires additional drugs for ___ pain control.
11. Remifentanil is known to be ___, making it a costly option.

Answer 12

1. mu
2. 0.5 - 1 mcg
3. 0.125-0.375 mcg/kg/min
4. 6 minutes
5. plasma esterases
6. respiratory
7. bradycardia
8. 70%
9. neuro, carotid, eye, TIVA
10. quick, post-operative
11. expensive

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Question 13

Onset of remifentanil is
A.60-90 seconds
B.45-60seconds
C.15-30 seconds
D. 30-60 seconds

Answer 13

D. 30-60 seconds