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Pharmacology > CNS Morphine > Flashcards

CNS Morphine Flashcards

1
Q

Define analgesic

A

The drug which relieves pain of any origin is called analgesic

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2
Q

Classify analgesic

A

1)OpoidalNarcotic analgesic
2)Non opoidal ? Non narcotic analgesic

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3
Q

Opoidal? Narcotic analgesic

A

Morphine
Pethidine
Tramadol
Fentanyl
Pentazosine
Methadone
Nalbuphine

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4
Q

Non opoidal ? Non narcotic analgesic

A

Paracetamol
Aspirin
Diclofenac
Ketorolac
Aceclofenac
Ibuprofen
Indomethasin
Naproxen
Tenoxicam

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5
Q

Classification of opoidal analgesic

A

Acc to sources : natural , semi synthetic , synthetic
Acc to efficacy : low efficacy , high efficacy

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6
Q

ACC to source

A

NATURAL = morphine , codeine , endorphins , dynorphine , enkephaline

SEMI SYNTHETIC = Diamorphine , Dihydrocodeine , Hydrocodeine , Oxycodeine , Oxymorphine

SYNTHETIC = Pethidine , Fentanyl , pentazosine , Nalbuphine , Loperamide

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7
Q

ACC TO EFFICACY

A

HIGH EFFICACY = Morphine , Pethidine , Tramadol , Fentanyl , Diamorphine

LOW EFFICACY = Codeine , Dihydrocodeine , Pentazocine, Nalbuphine

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8
Q

Properties of narcotic / opoidal / morphine

A

They act in CNSS
Causes CNS depression (narcosis )- sedation
Active in visceral pain
Highly potent analgesic
No anti inflammatory and anti pyretic action
Can be used in labour pain
They have low TI
Chance of addiction , dependence

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9
Q

Pharmacological action of morphine

A

CNS EFFECTS
Analgesia , Sedation , Respiratory depression , Nausea and Vomitting , Cough suppression , Hyperthermia , Euphoria , Miosis

PERIPHERAL EFFECTS
Bradycardia , Constipation , increased biliary pressure , Urinary retention , Oliguria , Prolong labour , Warming and itching of skin , Galactorrhoea

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10
Q

Clinical uses of morphine

A

1)Diagnosed visceral pain = pancreatitis , pericarditis , pleurisy , cholecystitis , pyelonephritis
2) Post operative pain
3)Cancer pain
4) Burn pain
5) MI
6) Acute LVF
7) Cough suppression
8)Spinal anaesthesia (I/v0

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11
Q

A/ e of Morphine

A

Nausea
Vomitting
Respiratory depression
Cough suppression
Shivering
Warming
Itching
Sedation
Miosis
Constipation
Urinary retention
Oliguria
Orthostetis hypotension
Hypotension
Bradycardia
Euphoria
Dependence
Addiction liability

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12
Q

Contraindications of Morphine

A

1) Undiagnosed acute abdomen
2) Bronchial asthma
3)Pregnancy
4)Head. Injury
5)Convulsive disorder
6)Biliary colic
7) Acute renal failure

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13
Q

Why morphine contraindicated in undiagnosed visceral pain?

A

Morphine relieve visceral pain but proper diagnosis is not possible so complication may be developed ( rupture of viscera may occur ).

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14
Q

Morphine contraindicated in pregnancy

A

Morphine crosses blood placental barrier and may cause foetal respiratory depression and intrauterine foetal death may occur

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15
Q

Morphine is contraindicated in head injury

A

C/ F of head injury = vomitting, bradycardia , pin point pupil
Morphine also causes Vomitting , bradycardia , pin point pupil
So diagnosis and prognosis is difficult

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16
Q

Morphine is contraindicated on bronchial asthma

A

Morphine releases histamine from mast cell which causes bronchoconstriction and aggravation of bronchial asthma

17
Q

Why Pethidine preferred in labour pain

A

Morphine crosses placenta and cannot metabolised so it has more duration of action and more chance of respiratory distress.
Pethidine rapidly metabolised in the placenta , less chance of foetal respiratory distress

18
Q

M/A of morphine

A

Morphine/ Pethidine

1) Acts in presynaptic nerve terminal by bind with opoidal receptors ( meu , kappa , delta ) ==> Closing of Ca++ channel and NT release ( Glutamate ,Ach , NA, substance P) ==> Analgesic action

2) Acts in post synaptic terminal by bind with opoidal receptor ( meu) ==> opening of K+ channel ==.> Increase K+ conductance ==> hyperpolarization ==> blocking of pain pathway ==> Analgesic action

19
Q

Diff between morphine & Pethidine

A

Morphine = natural / P= synthetic
M= more potent ( 10 times ) / P= less potent
Duration of action 4_ 6 hrs / / 2- 3 hrs
Effect on eye = Miosis // Mydriasis
Not use in pregnancy // used
Atropine like effect present // absent
Tolerance develops quickly // slowly
Addiction liability more // less

20
Q

Opoidal receptors are

A

μ

δ

κ

Pharmacology (14 decks)

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