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MMLU / A 54-year-old woman comes to the emergency department because of severe jaw pain…

Problem

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question

A 54-year-old woman comes to the emergency department because of severe jaw pain since undergoing a painful dental procedure 1 day ago. The patient was prescribed codeine after the procedure and instructed to take the medication every 4 hours, but she has continued pain despite adherence to this analgesic regimen. Other members of her family also have experienced poor pain control with codeine. Which of the following is the most likely explanation for this therapeutic failure?

choices

  1. Decreased absorption of codeine
  2. Decreased metabolism of codeine to morphine
  3. Deficiency of κ receptors
  4. Increased plasma protein-binding of codeine

subject

professional_medicine

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