Opium analgesiac

Question 1

What are the antagonists for morphine?

Answer 1

naloxone and naltrexone

Question 2

What are the naturallly occurring opiods from the poppy plant

Answer 2

Morphine and codeine

Question 3

What is the most common route of admin of morphone

Answer 3

Oral
50% metabolised by liver

Question 4

what route requires a higher dose or morphone and why

paraenteral (IV) or Orally (enteral)

Answer 4

Oral due to low bioavailibility (50%)
10mg orally is equivalent to 5 paraenterally

Question 5

Why does morphine cause kidney failure?

Answer 5

Accumulated in the kidneys and respiratory depression

Question 6

How long does a dose of morphine last

Answer 6

3-4 hours

Question 7

If you were to give a dose or morphine parenterally which would be the fastest and why

Intravenous
subcutaneous
Intramuscularly

Answer 7

IV
Higher blood flow

Question 8

what is in the spinal cord that allows drugs to be administered through an epidural

Answer 8

Opiod receptors in spinarl cord

Question 9

what is fentanyl soluble in and its best route for not getting highs and lows

Answer 9

Lipid soluble
Transdermal skin patch change every 3-4 days

Question 10

What type of route should lipid-soluble drugs be given through

Answer 10

Transdermal skin patch

Question 11

what are opiod receptors

Answer 11

G coupled receptors

Question 12

What are the main opioid receptors?

Answer 12

DOP, KOP, MOP, NOP

Question 13

Define potency

Answer 13

binding affinity

Question 14

Define efficacy

Answer 14

The possibility of a maximal drug response

Question 15

If diamorphine is prescribed at 5mg, what are the relative doses for

Morphine and pethidine

Answer 15

10mg and 100mg

Question 16

Describe tolerance and dependence

Answer 16

Tolerance is the downregulation or receptors due to prolonged use and need a higher dose for the same effect

Dependence is craving, euphoria, physical

Question 17

what are some side effects of prescribing opiod systematically

Answer 17

Opioid receptors exist outside the pain system
side effects include RESPIRATORY DEPRESSION, constipation, vomiting, etc

Question 18

what length of half life does naxolene have

Answer 18

short

Question 19

What cytochrome does codeine have to be metabolised at

Answer 19

CYP2D6

Question 20

What is morpine metabolised to

Answer 20

Morphine 6 glucuronide, which is more portent

Question 21

at what renal capacity should you not prescribe morphine

Answer 21

below 30%

Question 22

Is tramadol an agonist or antagonist

Answer 22

Agonist

Question 23

at what cytochrome is tramadol metabolised at

Answer 23

same as codeine - CYP2D6