A 63-year-old with eGFR 22 mL/min/1.73 m² becomes drowsy after two doses of morphine 10 mg every 4 hours. Which pharmacokinetic explanation is most

Question

A 63-year-old with eGFR 22 mL/min/1.73 m² becomes drowsy after two doses of morphine 10 mg every 4 hours. Which pharmacokinetic explanation is most likely?

Accepted Answer

Renally cleared morphine glucuronides have accumulated after dosing

Answer

Hepatic morphine activation has accelerated because renal function fell

Answer

Plasma protein binding has prevented morphine from reaching opioid receptors

Answer

Urinary morphine elimination has accelerated and precipitated opioid withdrawal

Answer

Intestinal morphine absorption has doubled because gastric pH increased

Morphine in severe renal impairment — GPhC CRA MCQ

A 63-year-old with eGFR 22 mL/min/1.73 m² becomes drowsy after two doses of morphine 10 mg every 4 hours. Which pharmacokinetic explanation is most likely?