Question

mAke a drug study for morphine and Ketamin drip

Answer 1

KETAMIN

Ketamin developed in 1960,as an anaesthetic agent.

It is a phencyclidine derivative.

Commonly used as an analgesic in emergency medicine, and an adjuvant drug in perioperative setting, and a third line adjuvant drug in opioid resistant pain in palliative care.

Recently it started using for treatment of depression and mood disorders.

MECHANISM OF ACTION

Ketamin interacts with N -methyl- D- aspartate(NMDA) receptors, opioid receptors ,monoaminergic receptors,muscarinic receptors and voltage sensitive Ca ion channels. Unlike other general anaesthetic agents, ketamin does not interact with GABA receptors.

INDICATIONS

General anaesthesia

Supplimenting low-potency agents such as nitrous oxide

Short term procedural sedation

Rapid sequence intubation

SIDE EFFECTS

Anaphylaxis

Arrhythmia, elevated BP, bradycardia

Anorexia, nausea, vomiting

Muscle stiffness/spasm/toxic clonic movements

Confusion, seizures

Amnesia, anxiety, confusion

Apnea, laryngospasm

MORPHINE

Morphine is an analgesic of opiate family.

First obtained from poppy seeds, in 1805

Acts directly on the central nervous system to reduce the feeling of pain.

Mechanism of action

Morphine had an affinity to delta, kappa and mu opioid receptors, it binds to mu opioid receptors in the central nervous system, and the peripheral nervous system . The net effect of morphine is the activation of descending inhibitory pathways of CNS and PNS. Which results in overall inhibition of nociceptive receptors.

Indications

For chronic, moderate to severe pain

Short term management of pain

Side effects

Constipation

Decreased peristalsis

Respiratory depression

Light headedness

Nausea

Vomiting

Depression

Urinary retention

Dizziness

Euphoria

Disphoria

Agitation

Drymouth

Anorexia