레미펜타닐

동물 종별 용량

용량은 면허 수의 전문가를 위한 임상 참고 자료입니다. 항상 최신 라벨과 개별 환자에 대해 확인하십시오.

투여 경로

금기

• Hypersensitivity to remifentanil or other fentanyl analogs
• Epidural or intrathecal administration (contraindicated due to the presence of glycine in the formulation)

이상반응

• Respiratory depression
• Apnea
• Bradyarrhythmias
• Hypotension
• Hyperthermia (noted in cats)
• Anaphylaxis (rare)

약물 상호작용

• CNS Depressants (e.g., propofol, isoflurane, thiopental) · Additive CNS and respiratory depression; remifentanil significantly reduces MAC and induction agent requirements.
• Diuretics · Opiates may decrease diuretic efficacy in patients with congestive heart failure.
• Monoamine Oxidase Inhibitors (e.g., amitraz, selegiline) · Severe and unpredictable opiate potentiation may occur; use is generally not recommended if an MAOI has been used within 14 days.
• Skeletal Muscle Relaxants · Remifentanil may enhance neuromuscular blockade.
• Nitrous Oxide · High doses of remifentanil combined with nitrous oxide may cause cardiovascular depression.
• Tricyclic Antidepressants (e.g., clomipramine, amitriptyline) · May exacerbate the effects of tricyclic antidepressants.
• Warfarin · Opiates may potentiate anticoagulant activity.

모니터링

• Cardiac rate and rhythm (ECG)
• Respiratory rate and depth / Capnography (ETCO2)
• Pulse oximetry (SpO2) or arterial blood gas
• Blood pressure (direct or indirect)
• Body temperature (especially in cats)

과용량

Overdosage manifests as an enhancement of the drug's pharmacological effects. **Clinical Signs**: * Apnea and severe respiratory depression * Chest-wall rigidity * Hypoxemia * Hypotension and severe bradycardia * Seizures **Treatment**: 1. **Discontinue drug administration immediately.** 2. Provide supportive therapy, primarily **mechanical ventilation** and oxygen administration. Because the drug is cleared so rapidly by tissue esterases, this is often the only intervention required. 3. Administer IV fluids, and use **glycopyrrolate or atropine** to manage bradycardia or hypotension. 4. **Naloxone** may be used to reverse mu-opioid activity, but caution is advised as it can lead to acute pain and sympathetic hyperactivity.