Palliative Care Flashcards
1
Q
What is the problem with using codeine in palliative care?
A
Ultra rapid metabolisers vs poor metabolisers
Codeine is metabolised to morphine by Cytochrome P450 CYP2D6, if people have a highly functioning enzyme they end up with a significant peak and lots of side effects (toxicity) and people with a poor functioning enzyme won’t have any response.
2
Q
How is morphine excreted?
A
90% renal excretion
3
Q
What receptor does methadone work on?
A
NMDA receptor antagonist - noradrenaline and serotonin reuptake inhibitor
