Ultiva

As an opioid analgesic adjunct for use w/ other agents during induction &/or maintenance of general anaesth in conjunction w/ controlled ventilation. Provision of analgesia in mechanically ventilated intensive care patients ≥18 yr.

General anaesth Adult Induction: 0.5-1 mcg/kg/min as infusion, w/ or w/o an initial bolus inj of 1 mcg/kg over not <30 sec. Maintenance in ventilated patients: Rate can be titrated upward in 25-100% increments or downward in 25-50% decrements, every 2-5 min to attain the desired level of μ-opioid response. Childn 1-12 yr Maintenance: 0.25 mcg/kg/min as infusion. Cardiac anaesth Induction: 1 mcg/kg/min. Maintenance: The infusion rate of Ultiva can be titrated according to patient need. 1 mg High risk cardiac patient Max bolus dose: 0.5 mcg/kg. Intensive care Initially 0.1-0.15 mcg/kg/min, may be titrated in increments of 0.025 mcg/kg/min. 1 mg Allow at least 5 min period between dose adjustments. 1 mg Elderly (>65 yr) ¹/₂ the recommended adult dose, then titrated to individual need. 1 mg Obese Reduce & base upon ideal body wt.

Hypersensitivity to any of excipients of the prep & other fentanyl analogues. Epidural & intrathecal use. Not for use as a sole agent for induction of anaesth.

Hypersensitivity to opioids of a different class. Use in mechanically ventilated intensive care patients is not recommended for duration of treatment >3 days. Muscle rigidity; marked resp depression; dependency. May affect a patient's ability to drive safely. Pregnancy & lactation. Neonates/infants <1 yr. Debilitated, hypovolaemic patients & elderly. 1 mg No residual opioid activity present w/in 5-10 min after discontinuation. Sedation, resp depression, coma & death when concomitantly used w/ sedative medicines (eg, benzodiazepines) or related drugs. W/drawal syndrome after therapy cessation w/ repeated administration at short term intervals for prolonged periods. Reports of w/drawal symptoms (eg, tachycardia, HTN & agitation) upon abrupt cessation (particularly after prolonged administration of >3 days). Physical & psychological dependence & opioid use disorder. Do not drive or operate machinery. Use during pregnancy only if potential benefit justifies potential risk to foetus. Discontinue breast-feeding for 24 hr following administration.

Acute resp depression, bradycardia, hypotension &/or skeletal muscle rigidity. Post-op shivering, apnoea, hypoxia, pruritus, constipation, sedation, nausea & vomiting. Post-op HTN & aches. 1 mg: Skeletal muscle rigidity; hypotension; nausea, vomiting. Bradycardia; post-op HTN; acute resp depression, apnoea, cough; pruritus; post-op shivering.

Decreases amounts or doses of inhaled & IV anaesth & benzodiazepines required for anaesth. Increased incidence of adverse effects w/ CNS depressants if their doses are not reduced. Exacerbated CV effects w/ cardiac depressant drugs eg, β-blockers & Ca-channel blocking agents. 1 mg: May increase risk of serotonin syndrome w/ SSRIs, SNRIs or MAOIs.

Anaesthetics - Local & General

N01AH06 - remifentanil ; Belongs to the class of opioid anesthetics. Used as general anesthetics.

DD, P₁S₁S₃