Opioids Flashcards

1
Q

Fentanyl: Class

A

Opioid agonist

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Fentanyl: Use

A

Reduce pain
Postoperative analgesia
Decrease Somatic and Autonomic response

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Fentanyl: Mechanism of Action

A

Binds to Mu1, Mu2, Kappa and delta receptors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Fentanyl: Dose

A

Induction: 1 mcg/kg
Infusion: 0.01 mcg/kg/min

Small dose Bolus: 25 mcg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Fentanyl: Pharmacokinetics

A

Absorption: IM, IV, epidural/intrathecal, transdermal, transmucosal

Onset: 2 minutes
Duration of Action: 30 minutes

Metabolism: Hepatic

Excretion: Feces and Urine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Fentanyl: Contraindications

A

Hypersensitivity
Severe Respiratory depression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Fentanyl: Considerations

A

Decreases ventilatory response to hypoxia and hypercapnia
Bradycardia
Decreased Gastric motility
Reduced Stress response
?Promote cancer cell proliferation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Hydromorphone / Dilaudid: Class

A

Opioid Agonist

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Hydromorphone / Dilaudid: Use

A

Pain management

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Hydromorphone / Dilaudid: Mechanism of Action

A

Binds to Mu1, Mu2, Kappa and delta receptors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Hydromorphone / Dilaudid: Dose

A

IV 0.2 mg Bolus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Hydromorphone / Dilaudid: Pharmacokinetics

A

Absorption: PO, IV, Epidural, Intrathecal

Onset: 15 minutes
Duration of Action: 4 hours

Metabolism: Hepatic

Excretion: Kidneys

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Hydromorphone / Dilaudid: Contraindications

A

Severe Respiratory Suppression
Hypersensitivity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Hydromorphone / Dilaudid: Considerations

A

Decreases ventilatory response to hypoxia and hypercapnia
Bradycardia
Decreased Gastric motility
Reduced Stress response
?Promote cancer cell proliferation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Meperidine: Class

A

Opioid Agonist

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Meperidine: Use

A

Post op Shivering

17
Q

Meperidine: Mechanism of Action

A

Binds to Mu1, Mu2, Kappa and delta receptors

18
Q

Meperidine: Dose

A

IV Bolus 12.5 mg

19
Q

Meperidine: Pharmacokinetics

A

Absorption: PO, IV, IM

Onset: 5 minutes
Duration of Action: 2 hours

Metabolism: hepatic
ACTIVE METABOLITE = Normeperidine

Excretion: Kidneys

20
Q

Meperidine: Contraindications

A

Hypersensitivity
Patient taking MAOIs
Renal Failure d/t active metabolite

21
Q

Meperidine: Considerations

A

Histamine release can cause Hypotension/Bronchoconstriction

Similar structure as Atropine –> Tachycardia

Active metabolite: Normeperidine has longer 1/2 life and lowers seizure threshold

22
Q

Remifentanil: Class

A

Opioid Agonist

23
Q

Remifentanil: Use

A

Induction
Intraoperative pain management

24
Q

Remifentanil: Mechanism of Action

A

Opioids bind to Mu1, Mu2, Kappa, and delta receptors to decrease neurotransmitter release by increasing potassium efflux and MARK cascade and decreasing adenyl cyclase production and calcium influx of ascending and descending pain pathways

25
Q

Remifentanil: Dose

A

Induction: 2 mcg/kg
IV Infusion: 0.05 mcg/kg/min

26
Q

Remifentanil: Pharmacokinetics

A

Absorption: IV

Onset: 1 minute
Duration of Action: 5 minutes

Metabolism: Ester hydrolysis

Excretion: Kidneys

27
Q

Remifentanil: Contraindictions

A

Not for spinal anesthesia
Bradycardia
High risk for Post op Pain

28
Q

Remifentanil: Considerations

A

Risk for muscle rigidity

Good Induction drug for when NMB is contraindicated

Induction dose has high risk for Bradycardia –> Pair with ephedrine

A good choice for patients with renal and/or hepatic failure

Post-op Hyperalgesia