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Running head: MORPHINE Questions and Answers: Morphine [STUDENT NAME] [COURSE NAME] [DATE] Section 1. Sources of variability in drug metabolism In relation to the metabolism of morphine discuss the influence of host (e.g. disease states) and environmental factors in terms of enzyme induction and/or inhibition on the metabolism of morphine.


The enzymes form active analgesic metabolites and in some cases toxic metabolites as well. This would indicate that environmental factors that could inhibit or increase the effectiveness of morphine would include conjoint use of other drugs that reduce or inhibit the effect of liver enzymes; liver disease or a liver dysfunction and any drugs that can increase enzyme levels in the liver itself. Section 2. Drug-Drug Interactions For morphine: i. List all known drug-drug interactions involving the metabolism of morphine. According to Interactive drug-drug search tool for morphine there are 28 serious drug-drug interactions (, 2011). The sixteen most common ones are listed in the table below: Ambien (zolpidem) Ativan (lorazepam) Cymbalta (duloxetine) Flexeril (cyclobenzaprine) Klonopin (clonazepam) Lasix (furosemide) Lexapro (escitalopram) Lyrica (pregabalin) Neurontin (gabapentin) OxyContin (oxycodone) Phenergan (promethazine) Plavix (clopidogrel) Seroquel (quetiapine) Vicodin (acetaminophen/hydrocodone) Xanax (alprazolam) Zoloft (sertraline) ii. Explain the mechanism of each of the interactions (i.e. Drug A inhibits the metabolism of Drug B by Enzyme X). ...
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