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Pronunciation

re-mi-FEN-ta-nil

Classifications

Therapeutic Classification: analgesic adjuncts, opioid analgesics

Pharmacologic Classification: opioid agonists

Indications

High Alert


Action

  • Binds to opiate receptors in the CNS, altering the response to and perception of pain.
  • Produces CNS depression.
Therapeutic effects:
  • Supplement in anesthesia.
  • Decreased pain.

Pharmacokinetics

Absorption: IV administration results in complete bioavailability.

Distribution: Widely distributed to tissues.

Metabolism/Excretion: Metabolized by blood and tissue esterases, metabolites are excreted by the kidneys.

Half-Life: 3–10 min.

Time/Action Profile

(analgesia)
ROUTEONSETPEAKDURATION
IVrapid3–5 min5–10 min



Respiratory depression may last longer than analgesia.



Contraind./Precautions

Contraindicated in:

Use Cautiously in:

Adv. Reactions/Side Effects

CV: arrhythmias, bradycardia, circulatory depression, hypotension

Derm: facial itching

EENT: blurred/double vision

GI: biliary spasm, nausea/vomiting ( in children)

MS: skeletal and thoracic muscle rigidity, shivering ( in children)

Neuro: confusion, paradoxical excitation/delirium

Resp: allodynia, APNEA, LARYNGOSPASM, opioid-induced hyperalgesia, RESPIRATORY DEPRESSION, allergic bronchospasm

Interactions

Drug-drug:

Route/Dosage

Induction of Anesthesia

Maintenance of Anesthesia

Continuation as an Analgesic in Immediately Postoperative Period

Monitored Anesthesia Care (Remifentanil Alone)

Monitored Anesthesia Care (Remifentanil + Midazolam)

Coronary Artery Bypass Surgery

Availability

(Generic available)

Assessment

Lab Test Considerations:

Toxicity and Overdose:

Implementation

IV Administration:

Patient/Family Teaching

Evaluation/Desired Outcomes

US Brand Names

Ultiva

Contr. Subst. Schedule

Schedule II (C-II)