You are an anesthesia provider evaluating John, a 57 year old male undergoing a craniotomy with a past medical history of obesity, hypertension and diabetes and previous history of prolonged emergence and postoperative nausea and vomiting. What medications would you give John using TIVA for his craniotomy? At which junctures could you use Ultiva and what dose would you give him?

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Ultiva (remifentanil) by GlaxoSmithKline and Abbott is a short acting opioid analgesic approved by the FDA in 1999 for induction and maintenance anesthesia and for general analgesia during anesthesia. The app is made by Mylan pharmaceuticals who also make the app Generic Brand Reference (GBR) recently reviewed on iMedicalApps and the MyEpiPen app.

The purpose of Mylan’s Ultiva app is to provide anesthesia providers dosing suggestions for Ultiva at the point of care and (more likely) increase the use of the drug.  The app is divided into six anesthesia cases and one dosing guide. The anesthesia cases range from craniotomy to gastric bypass and include options for both total intravenous anesthesia (TIVA) and/or a balanced approach with inhalational agents along with IV meds. The app uses these cases to highlight the use of Ultiva in the preoperative, induction, maintenance and postoperative areas of anesthesia.

Content: Can I trust the app’s health and medical information?

Yes. The app was developed by the company that produces the generic version of Ultiva, remifentanil.  The app contains the entire package insert and dosing guide of the drug. The cases appear to be evidence based, but lack information on the other drugs mentioned focusing almost exclusively on the use of Ultiva.  The app obviously has some conflicts of interest as it was developed by pharma and is dedicated solely to the use of Ultiva in general anesthesia cases.  The app includes methods of contacting the maker of Ultiva in the dosing guide and package insert sections of the app.

Usability: will the app work as expected and in a meaningful way?

Yes, to a degree. The app appears to provide a wide variety of cases in which Ultiva could be used and gives providers the proper doses for Ultiva and other anesthesia drugs such as propofol.  However, almost all of the safety information centers around Ultiva. The app does not contain a dosing guide for any other anesthetic drugs other than Ultiva.

Privacy: how is personal data protected and used?

Not applicable. The app does not appear to collect or ask for any privacy information. On the first screen upon opening the app it does ask if you are a US healthcare provider. If you click “yes”, it opens the app to the case scenarios. If you click “no”, the app exits and takes you to

Disclaimer: The views expressed are those of the author(s) and do not reflect the official policy of the Department of the Army, the Department of Defense or the U.S. Government.

  • Price
    • Free
    • Case based approach to the use of Ultiva for anesthesia.
    • Includes information on anesthesia stages from preop to induction to postop.
    • Includes dosing and safety data on Ultiva via specific cases and in general.
  • Dislikes
    • Seems very biased to the use of Ultiva.
    • No significant dosing or safety information on other anesthetic agents.
    • Heavy pharma influence in app design/function with annoying advertising throughout the app.
    • No Android version.
  • Overall

    A case based app for the point of care use of the anesthesia agent, Ultiva, provided by the pharmaceutical company that produces the generic version, remifentanil. The app is well made but is limited in used to anesthesia providers who use the drug frequently.

  • Overall Score
  • User Interface
  • Multimedia Usage
  • Price
  • Real World Applicability
  • Device Used For Review

    iPhone 6 running iOS 8.4.1

  • Available for DownloadiPhoneiPad