Remifentanil is unique among opioid analgesics because it is metabolized by:
- A Plasma esterases, giving it a context-insensitive half-life ✓
- B Hepatic glucuronidation to an inactive metabolite
- C Renal excretion of the unchanged drug
- D CYP3A4 oxidation to norremifentanil
Correct answer: A. Plasma esterases, giving it a context-insensitive half-life
Explanation
Remifentanil contains an ester linkage hydrolyzed by nonspecific plasma and tissue esterases. This gives it a rapid onset, short duration, and context-insensitive half-life that does not prolong with infusion duration. It does not accumulate in renal or hepatic impairment. This makes it ideal for infusion-based anesthesia where rapid recovery is needed.
Reference: Katzung Basic and Clinical Pharmacology, 15th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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