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NBME 21 Answers

nbme21/Block 4/Question#41

A 66-year-old man with stage IV colon cancer comes ...

Loperamide

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 +6  upvote downvote
submitted by hungrybox(254),

Loperamide: Agonist at u-opioid receptors. Slows gut motility (remember, constipation is a common side effect for all opioids).

quiz yourself:

Q: Would a junkie want to use Loperamide?

A: No, it has poor CNS penetration (which is why it has a low addictive potential).

Q: Would a junkie rather have morphine or buprenorphine?

A: Morphine. Both are u-opioid agonists, but morphine is a full agonist while buprenorphine is only a partial agonist.

Q: What about morphine vs. codeine?

A: Trick question, both are partial agonists.

cienfuegos  Thanks for passing off the knowledge. Regarding the last part, aren't morphine and codeine full agonists? +3  
champagnesupernova3  Yes they are +1  




 -3  upvote downvote
submitted by divya(1),

loperamide is basically diphenoxylate + atropine. atropine is added to reduce abuse potential by diphenoxylate.

divya  ugh sorry. this is wrong. idk why i always thought loperamide is diphhenoxylate +