Remifentanil is an ultra-short-acting opioid used during anesthesia. Its rapid offset of action, even after prolonged infusion, is explained by which metabolic pathway?

• A Rapid renal excretion unchanged
• B Hydrolysis by non-specific plasma and tissue esterases ✓
• C Hepatic glucuronidation by UGT enzymes
• D Rapid redistribution to adipose tissue

Explanation

Remifentanil contains an ester linkage that is rapidly hydrolyzed by non-specific esterases in blood and tissues, giving it a context-insensitive half-life of 3 to 10 minutes regardless of infusion duration. Unlike other opioids, it does not depend on hepatic or renal function for clearance, making it ideal for surgical anesthesia requiring rapid titration.

Reference: Katzung Basic and Clinical Pharmacology, 15th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.