Opiods Pharm

Question 1

Morphine

Answer 1

• selective mu receptor
• CNS:analgesia, drowsiness, euphoria/calming, nausea/vomiting, respiratory depression, cough suppression, lower seizure threshold
• CV: vasodilatation (histamine release, depressed baro-and chemo-receptor reflexes)
• GI: decreased GI motility, decreased secretions
• Renal:decreased urination and increased retention
• Skin and immune system modulation

Question 2

What effect does morphine have on pupil size?

Answer 2

It causes a contraction (miosis) dude to net increase of parasympathetic innervation

Question 3

What is morphine clinically useful for?

Answer 3

• Acute pain including trauma, peri-operative, acute coronary, nociceptive>neuropathic
• Anti-dyspneic first line therapy
• Weak antitussive and anti-diarrheal

Question 4

What are morphine’s pharmocokinetics?

Answer 4

Metabolized by liver. 10% to active M-6-G, 90% to M-3-G
Excreted in urine 90%
Half life: 1.5-4.5 hours

Question 5

What are morphine’s adverse side effects?

Answer 5

Seddation, nausea, constipation, delirium, urinary retention…
Often ease as tolerance develops days to weeks

Question 6

What are morphine’s contraindicaitons?

Answer 6

Abdominal conditions may be worse
Hepatitic impairment
Renal impairment

Question 7

What is codeine’s MOA?

Answer 7

Mu opiod receptor agonist, converted to morphine and depresses meduallary cough reflex

Question 8

What is codeine indicated for?

Answer 8

Weak analgesia, cough suppressant, diarrhea suppressant

Question 9

What are some side effects of codeine?

Answer 9

increased nausea/vomiting, worsening pruritus via histamine

Question 10

How is codeine metabolized?

Answer 10

Hepatic via conjugation CYP2D6

Question 11

What is diacetylmorphine’s MOA?

Answer 11

• Prodrug getting converted to morphine nad 6-acetylmorphine

- Acts are mu receptors primarily, but also some kappa and delta