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Asclepius1
06-03-2005, 07:17 AM
would anybody please help me with this ques?a 32 yr old opiate addicted pregnant mother about to give birth to her 2nd child,opts for painless delivery under systemic opioid analgesia.which of the following is not indicated?1.codeine2.fentanyl3.sufentanyl4.bupreno rphine5.meperidine

Asclepius1
06-21-2005, 04:40 PM
may be meperidine it will cause rlaxation as it has m blockin ability

gluconeogenesis
12-12-2005, 07:35 PM
would somebody please help me with this question?

A 32 yr old opiate addicted pregnant mother about to give birth
to her 2nd child, options for painless delivery under systemic
opioid analgesia. Which of the following is not indicated?

1.codeine
2.fentanyl
3.sufentanyl
4.buprenorphine
5.meperidine


I have not been able to determine the correct answer yet.
I have mainly looked at my pharmacology book and searched
via print.google.com. The excerpts from anaesthesia and
obstetric anaesthesia books did not yield immediate answers.
I found that epidural analgesia is the most effective and that
if you administer an opiate, the most commonly used analgesic
is "pethidine". It reduces pain, but does not eliminate it.

All of the drugs listed above are opioid analgesics. I would
avoid a drug that has a systemic effect thus causing respiratory
depression. I would also avoid the drugs fentanyl, sufentanil,
and alfentanil (not a choice) that cause "truncal rigidity".
(Katzung, Bertram, Basic & Clinical Pharmacology, ninth ed. 2004, pg 499)

Common opioid analgesics
Generic, Brand name, Intrinsic activity
codeine, , moderate activity
fentanyl, sublimaze, high activity
sufentanil, sufenta, high activity
buprenorphine, buprenex, high activity
meperidine, demerol, high activity
(Katzung, Bertram, Basic & Clinical Pharmacology, ninth ed. 2004, pg 499)

Fetal dependency, recognition, treatment
- Fetus may become dependent when mother chronically abuses opiods.
- May exhibit withdrawal symptoms in early postpartum time period.
- As small as a daily 6mg dose of heroin or equivalent drug by mother
may result in mild withdrawal symptoms with twice the dosage causing
severe withdrawal
- symptoms irritability, schrill crying, diarhea, possible seizures
- recognition by careful history and physical examination
- treatment primarily for relief of symptoms of withdrawal
mild -> diazepam, severe -> camphorated tincture of opium
sometimes methadone
(Katzung, Bertram, Basic & Clinical Pharmacology, ninth ed. 2004, pg 509)


"In addition to development of tolerance, persistant administration
of opioid analgesics has been observed to increase the sensation of
pain"
(Katzung, Bertram, Basic & Clinical Pharmacology, ninth ed. 2004, pg 503)

mital82
01-07-2006, 09:38 PM
i think it is codeine because since she is addicted to opoids she has marked degree of tolerance. and codeine being a weak u agonist would not give enough effect of analgesia. so it is as if giving nothing.rest all r high potent analgesics

YODA
01-07-2006, 09:56 PM
buprenorphine is a partial agonist. giving it to an opiote addicted person can cause a withdrawel reaction.

never give a partial agonist to someone who is addicted, you could kill them, especially if they are going through the stress of child birth, and the threat to the fetus is even higher.







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