Compare and contrast the pharmacology of morphine, fentanyl and remifentanil.
The question asked for a comparison of the pharmacology (pharmacokinetics and
pharmacodynamics) of three commonly used opiates. Better answers made use of a
well constructed table with headings including chemistry, protein binding, lipid
solubility, half-lives, context sensitive half-time, volume of distribution, metabolism,
active metabolites, oral bioavailability, and clearance. A distinction should have
been clearly drawn between onset, peak, and duration of effect. CNS stimulant
effects as well as depressant effects, were expected to be listed.
Syllabus: G2d, 2d
Recommended sources: Anaesthesia, Miller Chp 11 and Pharmacological Basis of
Therapeutics, Goodman and Gillman, Chp 21