Paper I
2022 October (Supplementary) (2010 Scheme) · 40 marks · 120 min

Question

Morphine

Q33 marksShort Notes

Answer

Morphine is the prototype opioid analgesic, acting predominantly on mu (μ) receptors: mu-receptor bindingGi-protein coupling↓cAMPneuronal hyperpolarization → reduced pain-signal transmission and perception.

Actions: analgesia, sedation/euphoria, respiratory depression, miosis, antitussive action, reduced GI motility, nausea/vomiting (CTZ stimulation), histamine release.

Uses: severe acute pain (post-operative, MI), chronic cancer pain, acute pulmonary edema (preload reduction), pre-anesthetic medication.

Adverse effects: respiratory depression (most dangerous), constipation (no tolerance develops), sedation, tolerance and dependence, histamine-mediated hypotension/pruritus.

Contraindications: head injury/raised ICP, bronchial asthma, severe hepatic impairment, labour.

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