리미펜타닐

그림문자(GHS)

• 그림문자(GHS)

  

• 신호 어

  Danger

• 유해·위험 문구

  H302：삼키면 유해함

  H317：알레르기성 피부 반응을 일으킬 수 있음

  H370：장기(또는, 영향을 받은 알려진 모든 장기를 명시)에 손상을 일으킴(노출되어도 특정 표적장기 독성을 일으키지 않는다는 결정적인 노출경로가 있다면 노출경로를 기재)

• 예방조치문구

  P260：분진·흄·가스·미스트·증기·...·스프레이를 흡입하지 마시오.

  P261：분진·흄·가스·미스트·증기·...·스프레이의 흡입을 피하시오.

  P264：취급 후에는 손을 철저히 씻으시오.

  P264：취급 후에는 손을 철저히 씻으시오.

  P270：이 제품을 사용할 때에는 먹거나, 마시거나 흡연하지 마시오.

  P272：작업장 밖으로 오염된 의복을 반출하지 마시오.

  P280：보호장갑/보호의/보안경/안면보호구를 착용하시오.

  P301+P312：삼켜서 불편함을 느끼면 의료기관(의사)의 진찰을 받으시오.

  P302+P352：피부에 묻으면 다량의 물로 씻으시오.

  P307+P311：노출된 경우,독성 물질 센터 또는 의사에게 전화하기

  P321：(…) 처치를 하시오.

  P330：입을 씻어내시오.

  P333+P313：피부자극성 또는 홍반이 나타나면 의학적인 조치·조언를 구하시오.

  P363：다시 사용전 오염된 의류는 세척하시오.

  P405：밀봉하여 저장하시오.

  P501：...에 내용물 / 용기를 폐기 하시오.

리미펜타닐 화학적 특성, 용도, 생산

• 용도

  Analgesic.

• 정의

  ChEBI: A piperidinecarboxylate ester that is methyl piperidine-4-carboxylate in which the hydrogen attached to the nitrogen is substituted by a 3-methoxy-3-oxopropyl group and the hydrogen at position 4 is substituted the nitrogen of N-propanoy aniline.

• World Health Organization (WHO)

  Remifentanil is defined as an opioid narcotic with an addictionforming and addiction-sustaining liability similar to morphine.

• 일반 설명

  Remifentanil (Ultiva) was designed as a “soft drug.” Softdrugs are designed to undergo metabolism quickly and thushave ultrashort durations of action. In place of the ethylaromatic ring seen on the other piperidine opioids, remifentanilhas an ester group. This ester group is metabolizedby esterases in the blood and tissue to a weaklyactive metabolite (1:300–1:1,000 the potency of remifentanil). The n-octanol/water partition coefficient ofremifentanil is 17.9. The pKa of remifentanil is 7.07, thus itis predominately unionized at physiological pH. Both ofthese properties account for its rapid distribution across theblood-brain barrier (<1 minute). The ester hydrolysis leadsto a quick recovery (5–10 minutes) independent of durationof drug administration, renal, or liver function. The favorablepharmacodynamics of remifentanil have led to its usefor induction and maintenance of surgical anesthesia.

• Pharmacology

  Remifentanil is a MOP agonist with a similar potency to fentanyl and approximately 20 times more than alfentanil. It has a rapid blood–brain equilibration time of just over 1min, with a short context-sensitive half-life of 3–5min, which is unaffected by duration of infusion. This makes it ideally suited for infusion during anaesthesia and in critical care. It may be titrated rapidly to achieve the desired effect. Remifentanil is available as a lyophilised white crystalline powder containing glycine; it should not be administered via the epidural or intrathecal routes. There may be increased opioid sensitivity in hepatic disease, resulting in a lower dosage requirement. Other situations requiring a reduction in dose include haemorrhage and shock and when administering in elderly patients. The high clearance and low VD imply that the offset of effect is caused by metabolism rather than redistribution. Hypothermia, such as may occur in cardiac surgery, may reduce clearance by up to 20%.
  There is some evidence to suggest that acute opioid tolerance and hyperalgesia may occur, particularly after remifentanil infusions. If high doses are used without neuromuscular blockade, muscle rigidity may be a problem, though this is less likely if using a concentration of 100 μgml^-1 or less and an infusion rate of 0.2–0.5μgkg^-1 min^-1. Bradycardia has also been reported.

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