Opioids

Question 1

Fentanyl - Dose/Timing

Answer 1

• 10 – 150 µg/kg IV
• Onset: 30 seconds
• Peak: 5-15 minutes
• Duration: 30-60 minutes
• 100 mcg Fentanyl is approximately equal to Morphine 10 mg

Question 2

Fentanyl - Indications

Answer 2

• Post-op pain management
• Analgesia sedation prior to intubation
• Adjunct in induction and maintenance of general/regional anesthesia

Question 3

Fentanyl - Adverse Effects

Answer 3

• Respiratory depression
• Cardiac stability
• Double peak effect (recirculation) can occur –> durther respiratory depression
• Chest wall rigidity if given too fast
• Bradycardia
• Hypotension

Question 4

Sufentanil - Dose/Timing

Answer 4

• 8-30 mcg/kg IV
• 5-10 times more potent than fentanyl
• Onset: 1-3 mins
• Peak: 3-5 mins
• Duration: 20-45 mins

Question 5

Sufentanil - Indications

Answer 5

• Adjunct in induction and maintenance of general/regional anesthesia
• MD only

Question 6

Sufentanil - Adverse Effects

Answer 6

• Respiratory depression
• Bradycardia
• Hypotension
• Chest wall rigidity if given too fast

Question 7

Remifentanil - Dose/Timing

Answer 7

• 0.5-1 mcg/kg/min IV
• 1/2 the potency of fentanyl
• Onset: 1-3 mins
• Duration: 3-10 mins

Question 8

Remifentanil - Indications

Answer 8

• Adjunct in induction and maintenance of general/regional anesthesia
• Ultra short acting given by continuous infusion with no residual effects within 10 min of stopping infusion
• MD only

Question 9

Remifentanil - Adverse Effects

Answer 9

• Respiratory depression
• Bradycardia
• Hypotension
• Chest wall rigidity if given too fast

Question 10

Morphine - Dose/Timing

Answer 10

• 2-5 mg IV q 3-5 min
• Onset: <1 min
• Peak: 20 min
• Duration: 2-7 hr

Question 11

Morphine - Indications

Answer 11

Standard analgesic against which all are compared

Question 12

Morphine - Adverse Effects

Answer 12

• Respiratory depression
• Bradycardia
• Hypotension
• Histamine release

Question 13

Hydromorphone - Dose/Timing

Answer 13

• 0.02-0.04 mg
• dilute in 9mL NS syringe for ease of calculation of dose
• Hydromorphone 2 mg IV equals Morphine 10 mg IV

Question 14

Hydromorphone - Indications

Answer 14

Moderate to severe pain

Question 15

Hydromorphone - Adverse Effects

Answer 15

• Respiratory depression
• Hypotension
• N/V
• Constipation

Question 16

Demerol - Dose/Timing

Answer 16

• 10-25 mg IV

* 12.5-25 mg IV for the treatment of shivering

Question 17

Demerol - Indications

Answer 17

• Temporary relief of moderate to severe pain

* Treatment of shivering associated with general anesthesia

Question 18

Demerol - Adverse Effects

Answer 18

• Respiratory depression
• Hypotension
• Tachycardia
• Accumulation of metabolite normeperidine can cause excessive CNS stimulation