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Remifentanil is relatively context insensitive whilst fentanyl and thiopentone are examples of drugs which have significant context-sensitive changes in their half-life. [1] The Context-Sensitive Half-Time describes the time required for the plasma drug concentration to decline by 50% after terminating an infusion of a particular duration. [2]
0.05 (3–6 min context-sensitive half-life; 7–18 min elimination half-life) Instantaneously (from 5 to 15 sec) 15 minutes; rapid offset of effects necessitates continuous infusion for maintenance of anesthesia Protonitazene: 200 50 μg Ocfentanil: 125–250 40–80 μg Ro4-1539: 240–480 20–40 μg Isotonitazene: 500 20 μg Sufentanil: 500 ...
Remifentanil's short context-sensitive half-life makes it ideal for intense pain of short duration. As such, it has been used for analgesia in labor successfully; however, it is not as effective as epidural analgesia. [10] In combination with propofol, remifentanil is used for anesthesia of patients undergoing electroconvulsive therapy. [11]
To induce general anesthesia, propofol is the drug used almost exclusively, having largely replaced sodium thiopental. [13]It is often administered as part of an anesthesia maintenance technique called total intravenous anesthesia, using either manually programmed infusion pumps or computer-controlled infusion pumps in a process called target controlled infusion (TCI).
Fospropofol is metabolized in the liver by alkaline phosphatases to propofol, formaldehyde, and phosphate.The hepatic metabolism of this prodrug to an active metabolite means that peak plasma levels of propofol after the administration of a bolus of fospropofol are lower than for an equipotent dose of propofol and also that its clinical effect is more sustained.
MST Continus is a 12-hour release formula, therefore it is given 2 times per day. It is available in the following doses: 5 mg, 10 mg, 15 mg, 30 mg, 60 mg, 100 mg and 200 mg tablets (equating to between 0.416 mg/hour and 16.67 mg/hour).
At the typical dose, anesthesia is induced for the duration of about 5–10 minutes, though the half-life of drug metabolism is about 75 minutes, because etomidate is redistributed from the plasma to other tissues. Onset of action: 30–60 seconds; Peak effect: 1 minute; Duration: 3–5 minutes; terminated by redistribution
The effects are varied depending on the particular drug given. When anesthetists administer standard doses of these anesthetic drugs to a person with pseudocholinesterase deficiency, the patient experiences prolonged paralysis of the respiratory muscles, requiring an extended period of time during which the patient must be mechanically ventilated.