Narcotics: Remifentanil

Question 1

What is the brand name for Remifentanil commonly used in clinical settings?

Answer 1

Ultiva

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Question 2

Remifentanil MOA: Remi is primarily an agonist at which type of opioid receptor?

Answer 2

Mu

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Question 3

PP and TexWes Ref: The recommended loading dose range for Remifentanil over 1 minute is __ to __ mcg/kg.

Answer 3

0.5-1 mcg/kg

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Question 4

TexWes Ref: The onset of Remifentanil is __ to __ seconds.

Answer 4

30-60 seconds

Question 5

PP and TexWesRef: The recommended infusion rate for Remifentanil is __ to __ mcg/kg/min.

Answer 5

0.125-0.375 mcg/kg/min

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Question 6

Because of its ultra-short duration of action of __ to __ minutes, Remifentanil must be paired with another drug for post-op pain control.

Answer 6

DOA: 6 -8 minutes

Must cover for post op pain with another drug d/t quick ON and quick OFF

…d/t metabolized rapidly by plasma esterases

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Question 7

If a patient has been receiving a Remifentanil infusion, it should be stopped ___ minutes before attempting breathing trials.

Answer 7

6 minutes

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Question 8

Remifentanil is known for causing ___ respiratory depression and may also lead to ___.

Answer 8

Quick respiratory depression and may also lead to bradycardia

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Question 9

When using Remifentanil as an infusion (gtt), it can reduce the MAC (Minimum Alveolar Concentration) requirement by up to __ %.

Answer 9

70%

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Question 10

Remifentanil is commonly used in procedures such as:

A) Cardiac bypass surgery
B) Neuro, carotid endarterectomy, eye blocks, and TIVA (Total Intravenous Anesthesia)
C) Obstetric epidurals
D) Routine dental procedures

Answer 10

B) Neuro, carotid endarterectomy, eye blocks, and TIVA

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Question 11

Put it all together

1. Remifentanil is a ___ opioid agonist.
2. The loading dose of Remifentanil is ___ mcg over 1 minute.
3. The recommended infusion rate for Remifentanil is ___ mcg/kg/min.
4. If a patient has been receiving a Remifentanil infusion, it should be stopped ___ minutes before attempting breathing trials.
5. Remifentanil is metabolized by ___, making it independent of organ function.
6. One of the major side effects of Remifentanil is quick ___ depression.
7. Remifentanil can cause ___ as a cardiovascular side effect.
8. Using Remifentanil can lead to up to ___% reduction of MAC.
9. Remifentanil is commonly used for ___, ___ endarterectomy, ___ blocks, and ____.
10. Due to its ___ offset, Remifentanil requires additional drugs for ___ pain control.
11. Remifentanil is known to be ___, making it a costly option.

Answer 11

1. mu
2. 0.5 - 1 mcg
3. 0.125-0.375 mcg/kg/min
4. 6 minutes
5. plasma esterases
6. respiratory
7. bradycardia
8. 70%
9. neuro, carotid, eye, TIVA
10. quick, post-operative
11. expensive

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