Ultiva Overdosage

Symptoms: As with all potent opioid analgesics, overdose would be manifested by an extension of the pharmacologically predictable actions of remifentanil. Due to the very short duration of action of Ultiva, the potential for deleterious effects due to overdose are limited to the immediate time period following drug administration. Response to discontinuation of the drug is rapid with return to baseline within ten minutes.
Management: In the event of overdose, or suspected overdose, take the following actions: discontinue administration of Ultiva, maintain a patent airway, initiate assisted or controlled ventilation with oxygen, and maintain adequate cardiovascular function. If depressed respiration is associated with muscle rigidity, a neuromuscular blocking agent may be required to facilitate assisted or controlled respiration.
Intravenous fluids and vasopressor for the treatment of hypotension and other supportive measures may be employed.
Intravenous administration of an opioid antagonist such as naloxone may be given as a specific antidote to manage severe respiratory depression and muscle rigidity. The duration of respiratory depression following overdose with Ultiva is unlikely to exceed the duration of action of the opioid antagonist.