USMLE Forum Archives - USMLE Step 3 - medicine
medicine
bingousmle - 01-29-10 18:33
A 65-year-old man with chronic lymphocytic leukemia is hospitalized for pneumonia. There is no history of smoking or pulmonary disease. His treatment consists of ceftriaxone and clarithromycin; supportive therapy with fluids and oxygen; and, codeine, 25 mg, 3 times daily, for cough. Over the next 2 days, his fever resolves, but his level of consciousness rapidly deteriorates. Arterial blood gas measurements indicate a PaO2 of 56 mm Hg and a PaCO2 of 64 mm Hg. Administration of naloxone results in dramatic improvement in his level of consciousness, and his respiratory failure resolves. best explanation is
bingousmle - 01-29-10 18:33
A 65-year-old man with chronic lymphocytic leukemia is hospitalized for pneumonia. There is no history of smoking or pulmonary disease. His treatment consists of ceftriaxone and clarithromycin; supportive therapy with fluids and oxygen; and, codeine, 25 mg, 3 times daily, for cough. Over the next 2 days, his fever resolves, but his level of consciousness rapidly deteriorates. Arterial blood gas measurements indicate a PaO2 of 56 mm Hg and a PaCO2 of 64 mm Hg. Administration of naloxone results in dramatic improvement in his level of consciousness, and his respiratory failure resolves. best explanation is
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#1
Re: medicine conym5 - 01-29-10 23:45 My answer is: b.
Question is understandible but , really can not think the naswer, i am just guessing this answer, really good question.. Naloxone resolving the symptoms..hmm :?
#5
Re: medicine
bingousmle - 01-30-10 01:35 Codeine is activated and metabolized by CYP2D6 into morphine and then undergoes glucuronidation. Life-threatening intoxication can develop over a matter of days in patients who have multiple functional alleles of CYP2D6, resulting in ultra-rapid metabolism of opioids such as codeine into morphine.
#20
Re: medicine babbu5508 - 08-30-10 00:52 My answer is: a.
the patient was takng codeine, 25 mg, 3 times daily, for cough...which might have caused respratory depression by intoxication....
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