Opioid Agonists/Antagonists, Multimodal Flashcards
Morphine:
Dose
Onset
Peak
Duration
Dose: 1-10 mg IV
Onset: 10 to 20 mins (IV and IM)
Peak: 45 to 90 mins IM; 15 to 30 mins IV
Duration: 4-5 hours
How is Morphine metabolized?
Glucorinic acid conjugation
What are the two metabolites of morphine? Which is active? Inactive?
Morphine-3-glucoronide (Inactive)
Morphine-6-glucoride (Active)
Which active metabolite of Morphine contributes to late respiratory depression?
Morphine-6-Glucoronide
Which receptors does Meperidine/Pethidine agonize?
Mu and Kappa
What are the four analogues of Meperidine?
Fentanyl
Sufentanil
Alfentanil
Remifentanil
Meperidine
Dose:
Duration:
E 1/2 Time:
Metabolism:
Dose: 12.5 mg (Post-op shivering)
Duration: 2-4 hours
E 1/2 Time: 3-5 hours (35 hours with renal failure)
Metabolism: 90% Hepatic (Normeperidine)
Fentanyl dose for…
Analgesia?
Induction?
Adjunct with inhaled anesthetics?
Analgesia - 1 to 2 mcg/kg IV
Induction - 1.5 to 3 mcg/kg IV
Adjunct with inhaled anesthetics - 2 to 20 mcg/kg IV
Fentanyl dose for…
Surgical Anesthesia (Solo)
Intrathecal
Transmucosal (Oral)
Transdermal
Surgical Anesthesia (Solo): 50-150 mcg/kg IV
Intrathecal - 25 mcg
Transmucosal (Oral) - 5 to 20 mcg/kg
Transdermal - 75 to 100 mcg (18 hours steady delivery)
Sufentanil doses
Analgesia - 0.1 to 0.4 mcg/kg IV
Induction - 18.9 mcg/kg IV
Alfentanil dose for…
Induction laryngoscopy
Induction alone
Maintenance
Induction laryngoscopy - 15 to 30 mcg/kg IV
Induction alone - 150 to 300 mcg/kg IV
Maintenance - 25 to 150 mcg/kg/hours IV
Remifentanil induction dose? Maintenance?
Induction - 0.5 to 1.0 µg/kg IV over 30-60 secs
Maintenance - 0.25 to 1 µg/kg IV or 0.005 to 2 µg/kg/min IV
Hydromorphone dose?
0.5 mg IV (1 to 4 mg)
Codeine
E 1/2 Time
Metabolism
Cough suppressant dose
Analgesia dose
E 1/2 Time - 3 to 3.5 hours
Metabolism - Liver
Cough suppressant dose - 15 mg
Analgesia dose - 60 mg
120 mg of Codeine is equal to…
10 mg of Morphine
Fentanyl is ____ - ____ times more potent than morphine?
75 to 125
Pentazocine elimination 1/2 time?
2-3 hours
Pentazocine moderate chronic pain dose? What dose can cause analgesia, sedation, and depression of ventilation?
Moderate Pain Dose - 10 to 30 mg IV or 50 mg PO (Equivalent to Codeine 60 mg)
20 to 30 mg IM can cause analgesia, sedation, and depression of ventilation (SImilar to 10 mg of Morphine)
Butorphanol dose? Half-time? Metabolism?
2 to 3 mg IM or 0.5-2mg IV (Equal to 10 mg of Morphine)
2.5 to 3.5 hours
Hepatic