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Morphine
Pharm (Test 2)
| Question | Answer |
|---|---|
| True or False: Morphine is the only naturally occurring analgesic. | True |
| True or False: Morphine is used as the gold standard for opioid agonists. | True |
| Morphine has a comparatively (high or low?) lipid solubility. | low (the least of the opioid class) |
| Morphine moves (quickly or slowly?) across the BBB. | slowly (d/t low lipid solubility) |
| After IV administration of morphine, equilibrium between the brain and blood takes __________ min (peak CNS effect), and duration is about __________hrs. | 15-30 min; 4 hrs |
| Doses of _____-______mg/kg of morphine are used IM as premedication and IV as portion of general anesthesia. | 0.1-0.2mg/kg |
| Morphine (does or doesn't?) decrease the MAC of volatile agents. | does (dose dependent) |
| Morphine decreases the MAC of volatile agents with a ceiling effect at ______%MAC. | 65% |
| Only _______% of morphine administered enters the CNS at peak plasma cntns. | <0.1 % |
| For what 4 reasons does only <0.1% of morphine administered enters the CNS at peak plasma cntns? | 1)low lipid solubility 2)high degree of ionization at physiologic pH 3)high protein binding 4)rapid conjugation with glucoronic acid |
| Morphine (is or isn't?) taken up by lungs in first-pass. | isn't |
| Morphine hepatic clearance is (high or low?). | high |
| Hepatic clearance of morphine is dependent on... | hepatic blood flow |
| What are morphine's metabolites? Active or inactive? | morphine 3-glucuronide (75-85%) (inactive) & morphine 6-glucuronide (5-10%) (active) |
| What effects do morphine's metabolites have? | M6G produces analgesia and respiratory depression similar to morphine |
| How is M6G metabolized? | excreted renally, so renal failure causes accumulation of M6G and prolonged effect |
| True or False: Increased rates of renal metabolism of morphine may be possible when liver metabolism is impaired. | True |
| What are the differences of morphine action in women? | greater analgesic potency, slower onset and offset, no effect on apneic threshold, hypoxic sensitivity decrease (takes dec. PaO2 to make hypoxic drive kick in) |
| Morphine histamine displacement (is or isn't?) common. | is |
| How can H1 and H2 blockers affect morphine histamine displacement? | doesn't change the release of histamine, but prevents change in BP and SVR (will likely have rash, but no itching) |
Created by:
lindseymontgomery
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