Ultiva is a brand name of the generic opioid analgesic remifentanil. Ultiva has a fast onset and rapid recovery time. It’s administered via continuous injection for the management of severe acute pain during invasive surgical procedures. Ultiva has been effectively used during cardiac surgeries, craniotomies, gastric bypass surgery, and spinal surgery.
Ultiva achieves its pain-relieving effects by binding to specific opioid receptors. It’s twice as potent as fentanyl and is 100 to 200 times more powerful than morphine.
Ultiva is used as an adjunct to general anesthesia. Ultiva has a unique pharmacology that makes it ideal for use during invasive operative procedures. Most opioids are metabolized primarily by the liver. With these substances, high doses can lead to liver toxicity as the body struggles to process the drug. Ultiva, in contrast, undergoes rapid hydrolysis in non-specific tissues. This results in an incredibly short elimination half-life.
The body can eliminate half of the drug’s quantity from the body in just four minutes, following four hours of continuous infusion. This rapid clearance rate prevents remifentanil from reaching toxic concentrations in the blood plasma. Ultiva allows for short recovery times following surgery.
Ultiva is difficult to abuse, although a few cases have been documented. The drug’s short duration of action makes it unappealing for recreational abuse. In the hospital setting, Ultiva is typically administered via computerized infusion. This, combined with its short half-life, make clinical overdose cases equally rare.
In the event of an overdose, the primary symptom is severe respiratory depression. Ultiva is a powerful central nervous system depressant. It acts directly on the brainstem: the area of the brain responsible for regulating the instinct to breathe. The brainstem regulates respiration based off of carbon dioxide levels in the blood. Ultiva inhibits the brainstem’s ability to analyze carbon dioxide levels, leading to carbon dioxide toxicity in the blood and hypoxia (oxygen deprivation).
Pinpoint pupils are another primary sign of Ultiva overdose. This symptom is common in nearly all opioid overdose cases. As the patient’s condition deteriorates, the pupils will eventually transition to maximal dilation due to oxygen deprivation.
Histamine-based reactions, such as intense itchiness (pruritis), are also common. Itchiness is often managed through the administration of an antihistamine like Benadryl. Other side effects could include decreased heart rate (bradycardia), muscle rigidity, and dizziness. When nausea occurs, it usually passes quickly due to Ultiva’s short duration of action.
The amount of Ultiva necessary to overdose varies according to the patient’s age, weight, body fat percentage, the severity of the patient’s illness, and the type of procedure being performed. Ultiva can be administered via continuous infusion as part of an anesthesia technique call TIVA (Total Intravenous Anesthesia). The process uses computer-controlled pumps to achieve target plasma concentrations.
When the drug is administered for sedation, therapeutic doses range from 0.025 to 1.0 micrograms per kilogram per minute. During surgical procedures, adult doses range from 0.1 to 0.5 micrograms per kilogram per minute. Children typically require higher doses of up to 1.0 micrograms per kilogram per minute.
Ultiva presents a lower risk factor for rebounding respiratory depression compared to longer-acting opioids. In the event of an overdose, the priority should be to secure and protect the patient’s airway in order to support adequate respiration.
Controlled or assisted ventilation may be necessary. A bag-valve mask may be used if the patient is conscious. If the patient is unconscious, an endotracheal tube may be inserted into the patient’s throat to prevent the airway from becoming obstructed. Other supportive measures, such as oxygen therapy and vasopressors, may be used to address the development of pulmonary edema and cardiovascular depression.
If clinically significant respiratory depression is present, the administration of an opioid antagonist such as naloxone will be indicated. Naloxone rapidly reverses the effects of opioids like Ultiva by forcing them to break their bonds to opioid receptors.
When administered intravenously or intranasally, naloxone can negate the effects of opioids within seconds. In the case of severe overdose, multiple doses of naloxone may be required. Intervals of two to three minutes should be allowed between doses. Naloxone can trigger the onset of severe post-acute withdrawals in opioid-dependent patients.
If you or someone you love is struggling with opioid abuse, The Recovery Village is available to answer any questions that you may have. Visit us online at www.TheRecoveryVillage.com or call toll-free at 855-548-9825 to learn more about the road to recovery.
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