Remifentanil (Ultiva)

Indications

Pain

  • Acute Procedure-Associated Pain
  • Maintenance of Analgesia in the Intensive Care Unit Setting

Sedation

  • Maintenance of Sedation in the Intensive Care Unit Setting (see Sedation, [[Sedation]]): most studies were in surgical patients

Pharmacology

  • Opiate (see Opiates, [[Opiates]])
    • μ-Opioid Receptor Agonist: main mechanism of action
    • κ­Opioid Receptor Agonist: to some extent
    • Properties
      • Analgesic Effect
      • No Effect on Intracranial Pressure
      • No Effect on Seizure Threshold

Pharmacokinetics

  • Onset: 3-10 min
  • Half-Life: 3-4 min

Metabolism

  • Plasma Esterases
    • Metabolism is Not Affected by Hepatic/Renal Dysfunction
    • Drug Does Not Accumulate with Prolonged Infusion

Administration

  • IV (Load): 0.4-0.8 μg/kg
  • IV (Maintenance): 0.5-2.0 μg/kg/min

Dose Adjustment

  • Hepatic:
  • Renal:

Adverse Effects

Cardiovascular Adverse Effects

Gastrointestinal Adverse Effects

Pulmonary Adverse Effects


References

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