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1A B
Generic: Action:
Why does each drug act like this? - If N-Methyl substituent size is 3-5 (especially with unstauration or small carbocyclic ring) Antagonist at some or all receptors Nalorphine Agonist at one receptor & Antagonist at another. - 14-OH gp sterically forces the substituent to remain equatorial. Naloxone Pure antagonists at all receptors. Mention the use of drug (B). Naloxone: (Short-acting) Used to reverse coma and respiratory depression of Opioid overdoses. 2A B
Generic: Action:
Codiene
Dextromethorphan
What are the common str. similarities for both to act as antitussives? 3-O-CH3 derivatives of morphine and Levorphanol respectively. Potent antitussive agents. What are the proposed MOA for both? Centrally acting Decreasing the sensitivity of CNS cough centers to peripheral stimuli. Mention the proposed metabolism of one of them. Codiene Undergoes metabolic O-demethylation to morphine.
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3A B
Generic: Action:
Which one of them has better affinity for the receptor? Why? 6-Acetylmorphine has better affinity Its phenolic gp is free and will interact immediately with the analgesic receptors. Which of them is stronger in its action? Why? 3,6-diacetylmorphine (Heroine) is stronger in action Low opioid receptor affinity. BUT lipophilic BBB penetration Where the 3-acetyl gp is hydrolyzed by esterases to produce 6-Acetylmorphine. 6-Acetylmorphine agonist activity > Morphine. - "Euphoric rush": Rapid BBB penetration of Heroin and the conversion to a potent agonist. This makes this cpd a popular abuse drug.
4A B
Generic: Action:
Which of them is stronger? Why? Fentanyl is stronger No phenolic gp, but very lipophilic + rapid onset/short duration. Mention the specific use for both drugs. - Fentanyl 80X Morphine potency. Used with nitrous Oxide for balanced anesthesia. Fentanyl patch is used for severe chronic pain (provides analgesia for 72 hours). - Meperidine 1/4X Morphine potency. Used in child birth because of its rapid onset/short duration / No respiratory depression. Enumerate a better alternative for drug (A). Sufentanil - Alfentanil.
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5A B
Generic: Action:
Methadone Agonist
Which of them is stronger? Buprenorphine Mention the stereochemistry aspects of both indicating their uses. Buprenorphine An extra ring is added to make the molecule more rigid. Oripavines are very hydrophobic. Rigidification Limits the number of conformations that the molecule can adopt. Retain the active conformation for the desired target. Activity Selectivity Side effects. Used in Opiod addict ttt program Safe, no tolerance and blocks Heroin doses. Methadone Has a single asymmetric center (Marketed as a racemic mixture but the (-) isomer possesses almost all the analgesic activity). Used in opioid addict weaning programs (orally active with long duration of action). 6A B
Generic: Action:
Diphenoxylate Antidiarrheal
Hydrocodone Antitussive
Why does drug (A) co-administrated with Atropine? Atropine Block Ach "Anticholinergic: Abuse potential. Which is stronger, Drug (B) or Codeine? Hydrocodone is stronger than Codeine Mention the metabolism of drug (A) indicating its activity. Difenoxin: 5X more potent than Diphenoxylate ( CNS penetration - abuse potential).
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2-
Its metabolite
Difenoxin
3-
Antitussive
Dextromethorphan
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