Difference between revisions of "Opioids"
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+ | {| class="wikitable" | ||
+ | |+ Commonly Used Opioids | ||
+ | |- | ||
+ | ! Opioid !! Dose !! Onset !! Duration !! Elimination !! Unique effects/indications | ||
+ | |- | ||
+ | | Fentanyl || 1-20 ug/kg || 4-6 min || 15-30 min || Hepatic/Renal || Example | ||
+ | |- | ||
+ | | Sufentanyl || 0.3-1 ug/kg || 2-4 min || 5-15 min || Hepatic/Renal || Example | ||
+ | |- | ||
+ | | Remifentanyl || 0.1-0.3 ug/kg || 1-2 min || 2-5 min || Plasma esterases || Example | ||
+ | |- | ||
+ | | Alfentanyl || 15-50 ug/kg || Example || Example || Hepatic/Renal || Example | ||
+ | |- | ||
+ | | Morphine sulfate || 25-75 mg || 10-30 min || 2-5 hrs || Example || Can cause histamine release | ||
+ | |- | ||
+ | | Meperidine || Example || 10-30 min || 2-5 hrs || Example || Used for post-op shivering | ||
+ | |} | ||
+ | |||
* Don’t combine [[benzodiazepines]] and opioids. If you need to reverse, use [[flumazenil]]. | * Don’t combine [[benzodiazepines]] and opioids. If you need to reverse, use [[flumazenil]]. | ||
* Central loci of opioid action (descending inhibitory pain pathways) | * Central loci of opioid action (descending inhibitory pain pathways) |
Revision as of 20:50, 31 January 2023
Opioid | Dose | Onset | Duration | Elimination | Unique effects/indications |
---|---|---|---|---|---|
Fentanyl | 1-20 ug/kg | 4-6 min | 15-30 min | Hepatic/Renal | Example |
Sufentanyl | 0.3-1 ug/kg | 2-4 min | 5-15 min | Hepatic/Renal | Example |
Remifentanyl | 0.1-0.3 ug/kg | 1-2 min | 2-5 min | Plasma esterases | Example |
Alfentanyl | 15-50 ug/kg | Example | Example | Hepatic/Renal | Example |
Morphine sulfate | 25-75 mg | 10-30 min | 2-5 hrs | Example | Can cause histamine release |
Meperidine | Example | 10-30 min | 2-5 hrs | Example | Used for post-op shivering |
- Don’t combine benzodiazepines and opioids. If you need to reverse, use flumazenil.
- Central loci of opioid action (descending inhibitory pain pathways)
- PAG
- Nucleus Raphe magnus
- Rostral ventromedial medulla
Short-Acting
- Oxycodone, Hydromorphone, Morphine
- Morphine can cause rash/pruritis
Long-Acting
- Oxycodone ER = OxyContin
- Methadone
- Fentanyl is really only used intra-op or in palliative care.