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Pharm (Test 2)

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)