Opioids

Question 1

Morphine

Answer 1

long- acting, histamine release, renally- excreted active metabolite with opiate properties therefore beware in renal failure

Question 2

Dilaudid

Answer 2

long-acting, no active metabolites or histamine release, same onset/duration as morphine

Question 3

Demerol

Answer 3

euphoria, stimulates catecholamine release, beware in patients using MAOI’s, renally excreted active metabolite associated with seizure activity, renally excreted metabolite with seizure potential, therefore beware in renal failure

Question 4

Fentanyl/Alfentanil/Sufentanil

Answer 4

low doses produce brief effect, but larger doses are long- acting, increased incidence of chest wall rigidity compared with other opiates, no active metabolites

Question 5

Remifentanil

Answer 5

almost instantaneous onset/offset of action due to metabolism by plasma esterases, must be given as continuous infusion, significant incidence of chest wall rigidity and n/v