Morphine & Pethidine (Meperidine) Flashcards

1
Q

Morphine main mechanism ??

A

Pain transmission is inhibited

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2
Q

Pain associated neurotransmitters ??

A
  1. Substance P
  2. Acetylcholine
  3. Nor epinephrine
  4. Serotonin
  5. Glutamate

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2
Q

Morphine another mechanism ??

A
  1. Ophoid receptorninn post synaptic nerve terminal
  2. Ophoid receptor - MEU
  3. Open K channel
  4. Inc k efflux
  5. K conductance
  6. Hyperpolarization
  7. Inhibitory post synaptic potential - IPSP

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2
Q

Ophoid receptor type ??

A

G protein couple receptor

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3
Q

Moprhine mechanism in your own word ?

A
  1. Morphine binds with ophoid receptors in presynaptic nerve terminal
  2. Ophoid receptors - MICRO - DELTA - KAPPA
  3. Closure of Ca channel
  4. Dec Ca influx
  5. Decx relese of neurotransmitter

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4
Q

Indications of morphine ??

A
  1. Acute MI
  2. Severe somatic pain
  3. Chronic pain in terminal cancer patient
  4. Obstetric labor
  5. Acute pulmonary edema
  6. Shivering
  7. Cough suppression
  8. Non infective diarrhea

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5
Q

Effect of Morphine in MI ??

A
  1. Adequate analgesia
  2. Lower adrenergic drive
  3. Reduce pulmonary vascular resistance ‘
  4. Reduce systemic vascular resistance
  5. Reduce susceptibility to ventricular arrythmia

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5
Q

CNS Adverse/ effect of mrophine ?

A
  1. Delirium
  2. Sedation
  3. Myoclonus
  4. Seizures

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DM S S

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6
Q

Morphine effect in Acute Pulmonary Edema ???

A
  1. Reduced anxiety
  2. Reduced Cardiac preload
  3. Reduced afterload

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6
Q

Ophoid like anti-Diarrheal drug ??

A
  1. Loperamide
  2. Codeine
  3. Diphenoxylate

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7
Q

GI A/E of morphine ??

A
  1. Constipation
  2. Urinary retention

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8
Q

Respiratory A/E of morphine ??

A
  1. Respiratory depression
  2. Nausea / Vomiting

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9
Q

In head injury manifestation of morphine ??

A

Inc Intracranial Pressure

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10
Q

contraindications of morphine ?

A
  1. head injury
  2. 🤰
  3. impaired -pulmonary-renal - endocrine function
  4. undiagonised acute visceral pain
  5. combining a pure agonist with a weak partial agonist pentazocine
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10
Q

why pethidine/meperidine&raquo_space;> morphine ?

A
  1. it does not delay labour like morphine
  2. less cardio respiratory depression in fetus
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11
Q

functional classfication of morphine ?

pure agonist name ?

A
  1. morphine
  2. fenatyl
  3. heroine
  4. oxy & hydro codeine
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12
Q

partial agonists name ?

A
  1. buprenorphine
13
Q

antagonists name ?

A
  1. naloxone
  2. naltrexone
  3. nalmefene
14
Q

moderate agonists name ?

A

codeine

15
Q

according to origin ?

natural ophoid ?

A

morphine
codeine

16
Q

semisynthetic ophoid ?

A

buprenorphone
oxt & dihydrocodeine

17
Q

synthetic ophoid ?

A

pethidine
fenatyl
meperidine
nalbupine
afenatyl
su-fenatyl
remi-fenatyl

18
Q

CNS effects of morphine >?

selective depression of CNS ?

A
  1. Analgesia
  2. sedation
  3. sleep
  4. respirstory depression
  5. cough suppression
  6. hyperthermia
19
Q

selective stimulation of CNS by morphine ?

A
  1. vomiting
  2. miosis
  3. convulsions
  4. hyperactive spinal cord reflexs
20
Q

other CNS effect of Morphine >

A

dependence
changes in mood
euphoria
dysphoria

21
Q

PNS effect of morphine ?

A

analgesia

22
Q

other peripheral effects of morphine?

A
  1. CVS-bradycardia + hypotension
  2. GIT - constipation
  3. renal - urinary retention , dec RBF , anti-diuretics effect
  4. uterus - prolong labour
  5. neuroendocine - inc release of ADH
23
Q

which ophoid in obstetric labour /

A

meperidine

24
Q

antitussive drugs ?

A
  1. dextromethorphan
  2. codeine
25
Q

which ophoid in shivering ?

A
  1. pethidine
26
Q

endogenous ophoid peptides name ?

A
  1. endorphins
  2. dynorphins- A+ B
  3. enkephalin
27
Q

Analgesic drugs name /

A
  1. opioid/narcotic
  2. non-o/non-n - NSAID
28
Q

What is analgesic drug /

A

an analgesic is defined as a drug that relieves pain

29
Q

why morphine is restricted drug ?

A

cause - addiction

30
Q

why contraindicated in impaired respiratory function ?

A

may cause acute respiratory failure

31
Q

analgesic dose of morphine /

A

10mg

32
Q

analgesic dose of meperidine

A

100mg

33
Q

which drugs used as regular analgesic in post operative period ?

A
  1. ketorolac
  2. diclofenac
  3. naproxane
34
Q

morphine vs pethidine ?

basic 4 ta kotha

A
  1. M= natural
  2. late action
  3. long duration
  4. more potent

pethidine - opposite

35
Q

M VS P?

A/E Diye

A
  1. hypnotic effect
  2. respiratory depression
  3. cough suppression
  4. constipation
  5. urinary retensuion
36
Q

histamine realeas by which one ?

A

morphine
= bradycardia + hypotension

37
Q

how to tx a morphine addict ?

A
  1. long term substitutes - methadone + buprenorphine _ heroin
  2. b;locking response - naltrexone
  3. reducing continued drug use/reducing craving ? - baclofen + ibogaine