Remifentanil Ester Metabolism — FRCA Primary MCQ
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Correct answer: C — Non-specific tissue and plasma esterases
Remifentanil contains an ester linkage that is hydrolysed by non-specific tissue and plasma esterases (not plasma cholinesterase). This gives it a context-sensitive half-time of approximately 3-4 minutes regardless of infusion duration. Its metabolite (remifentanil acid) has negligible activity (1/4600th potency).
Reference: Peck Hill Williams 2014 Pharmacology for Anaesthesia and Intensive Care