Suggested Level of Knowlege: Detailed

LOs

BT_GS 1.42 Describe the pharmacokinetics of intravenous opioids (also refer to the Pain medicine clinical fundamental)

BT_PM 1.10 Describe the effect of physiological change and pathological disturbance on the pharmacology of the agents listed in learning outcome BT PM 1.9 (Opioids, Tramadol, Local anaesthetic agents,  NSAIDs,  Paracetamol,  NMDA antagonists,  Anticonvulsants,  Antidepressants,  Corticosteroids,  Inhalational analgesics - nitrous oxide,methoxyflurane), with special reference to the elderly

BT_PM 1.17 Describe the pharmacokinetics of intravenous opioids and their clinical applications

Past SAQs

2013.2, 2000.2 Explain how differences in the pharmacokinetics of alfentanil and fentanyl can influence the way they are administered intravenously.

2010.1 Compare and contrast the pharmacokinetics of orally and intravenously administered morphine and oxycodone.

2005.2, 2001.1, 2000.1 Define the term ‘context-sensitive half time’. How does it differ from the half life typically quoted for a drug? Illustrate this concept by comparing thiopentone vs. propofol and fentanyl vs. remifentanil.

2003.1 Explain how differences in the pharmacokinetics of alfentanil and fentanyl can influence the way they are administered intravenously.

NOTE

You will find the metabolism of the morphine related compounds much easier to understand if you know about their structure.

Opioid Pharmacokinetics