Opioids Flashcards
Morphine Dose
Intra: 1- 10 mg
PostOp: 2- 10 mg
Fentanyl Dose + Trade Name
Sublimaze
1 - 3 mcg/kg
Sufentanil Dose
Intra: 0.3 - 1 mcg/kg
Infusion: 0.5 - 1 mcg/kg/hr
Remifentanil Dose + Trade Name
Ultiva
DOSED on IDEAL BW
Loading 0.5 - 1 mcg/kg over 1 min
Infusion: 0.125 - 0.375 mcg/kg/min
Meperidine Dose + Trade Name
Demerol
Used for Post-op shivering
12.5 mg
Hydromorphone Dose + Trade Name
Dilaudid
Intra: 1- 4 mg
PostOp: 1.5 - 4 mg
Naloxone Dose + Trade Name
Narcan
40 - 80 mcg
Morphine Onset
10 - 20 min
Morphine Duration
4 - 5 hr
Fentanyl Onset
30 - 60 sec
Sufentanil Onset
30 - 60 sec
Fentanyl Duration
1 - 1.5 hr
Sufentanil Duration
1 - 1.5 hr
Remifentanil Onset
30 - 60 sec
Remifentanil Duration
6 - 8 min
Meperidine Onset
5 - 15 min
Meperidine Duration
2 - 4 hr
Hydromorphone Onset
5 - 15 min
Hydromorphone Duration
2 - 4 hr
Naloxone Onset
1 - 5 min
Naloxone Duration
30 min
Mu1
Analgesia
Euphoria
Miosis
Bradycardia
Hypothermia
Urinary Retention
Mu2
Analgesia
Resp Depression
Physical Dependence
Constipation
Kappa
Analgesia
Dysphoria
Sedation
Miosis
Diuresis
Delta
Analgesia
Resp Depression
Dependence
Urinary Retention
Opioid MOA
Activate mu, kappa, and delta receptors
Presynaptic inhibition of acetylcholine, dopamine, norepinephrine, Substance P
Decreased calcium channel activity
Increased potassium conductance
Hyperpolarize cell
Morphine Pharmacodynamics
Primarily mu 1 & mu 2
Active metabolite Morphine -6- glucuronide
Poor lipid solubility
Highly protein bound
Clearance: Renal
Fentanyl Pharmacodynamics
Mu 1 & Mu 2
Lipid Soluble
Non ionized form high in physiologic pH
Active metabolite: norfentanyl
Metabolism: Hepatic P450s
Clearance: Renal
Sufentanil Pharmacodynamics
Mu 1 & Mu 2
Lipid soluble
Metabolism: Hepatic
Clearance: Renal & Fecal
Remifentanil Pharmacodynamics
Mu 1 & Mu 2
lipid soluble
Metabolism: Plasma esterases
Clearance: Renal
Meperidine Pharmacodynamics
mu1, mu2, kappa
Active metabolite: normerperidine
Metabolism: Hepatic
Clearance: Renal
Hydromorphone Pharmacodynamics
Mu 1 & Mu 2
Water soluble
Metabolism: Hepatic
Naloxone Pharmacodynamics
Nonselective for Mu, Delta, Kappa
Opioid antagonist
Metabolism: Hepatic
Morphine E 1/2 time
2-3 hours
Naloxone E 1/2 time
1 - 1.5 hours
Hydromorphone E 1/2 time
3 - 5 hours
Remifentanil E 1/2 time
6 min
Sufentanil E 1/2 time
2-5 hours
Fentanyl E 1/2 time
3-7 hours