Opioids Flashcards
Morphine dose (intraop), onset, peak, duration.
dose: 0.1 - 1 mg/kg IV
onset: 1 min
peak: 5 - 20 min
duration: 2 - 7 hours
Meperidine dose - intraop
2.5 - 5 mg/kg IV
Fentanyl dose (intraop), onset, peak, duration.
dose: 2 - 150 mcg/kg IV
onset: 30 sec
peak: 5 - 15 min
duration: 30 - 60 min
Sufentanil dose, onset, peak, duration
dose: 0.25 - 30 mcg/kg IV
onset: 1 - 3 min
peak: 3 - 5 min
duration: 20 - 45 min
Dilaudid dose, onset, peak, duration.
dose: 0.01 - 0.04 mg/kg IV
Mepiridine:Morphine conversion
1:10 (x0.1)
Dilaudid:Morphine conversion
10:1 (x10)
Fentanyl:Morphine conversion
100:1 (x100)
Sufentanil:Morphine conersion
1000:1 (x1000)
Receptor for endorphins
Mu1 and Mu2
Receptor for enkephalins
Delta
Receptor for dynorphins
Kappa
Opioids are unique in producing what, without loss of what?
produce analgesia without loss of touch, proprioception, or consciousness
Are opioids agonists or antagonists?
agonists at opioid receptor sites in the CNS (brainstem and spinal cord) and outside the CNS in peripheral tissues
What are the principal effects of opioid receptor activation?
a decrease in neurotransmission
intracellularly - increased K conductance [leads to hyperpolarization], calcium channel inactivation, or both
What is produced by activation of mu1 receptors?
analgesia, bradycardia, hypothermia, urinary retention
What is produced by activation of mu2 receptors?
hypoventilation, bradycardia, constipation, and physical dependence
What is produced by activation of kappa receptors?
analgesia, dysphoria, sedation, diuresis, and miosis
What is produced by activation of the delta receptors?
analgesia, respiratory depression, physical dependence, constipation, and urinary retention
How is remifentanil different from other narcotics?
metabolized by plasma esterases, thus resulting in a context-sensitive half-time that is independent of the duration of its infusion.
What is the mechanism of action of ketorolac?
inhibits prostaglandin synthesis by decreasing cyclooxygenase activity
Ketorolac dose, onset, peak, duration.
dose: 30 mg IV
onset: 10 min
peak: 2 - 3 hours
duration: 6 - 8 hours
Ketorolac metabolism?
hepatic (CYP450)
Ketorolac elimination?
in the urine
Alfentanil dose - intraop
8 - 100 mcg/kg IV (loading dose)
0.5 - 3 mcg/kg/min (maintenance)
Remifentanil dose - intraop
1 mcg/kg IV (loading dose)
0.5 - 3 mcg/kg/min (maintenance)
