GasGasGas - The FRCA Primary Exam Podcast GasGasGas - Diamorphine for the FRCA Primary
May 30, 2025
Explore the fascinating world of diamorphine, including its chemical relationship to morphine and various formulations. Delve into how it interacts with opioid receptors and its clinical applications in pain management and palliative care. Learn the typical dosing and hear about its potential side effects across different organ systems. Discover the pharmacokinetics behind its absorption and metabolism, plus crucial information on reversal with naloxone. This episode wraps up with a sneak peek into neuraxial opioid pharmacology.
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Awkward Heroin Ward Anecdote
- Dr Gas Lurks accidentally told a child's father he would squirt heroin up the child's nose and had to backtrack quickly.
- He advises not to tell kids you will squirt heroin up their nose and to instead call it a nice painkiller.
Diamorphine Basics And Routes
- Diamorphine is a diacetylated morphine derivative available as powder for reconstitution in small ampoules.
- It can be administered IV, IM, intrathecal, epidural and intranasally among other routes.
Mechanism Of Action Concisely
- Diamorphine acts at G-protein coupled opioid receptors using Gi mechanisms to hyperpolarize neurons.
- It opens K+ channels, closes Ca2+ channels and inhibits adenylate cyclase, reducing cAMP and synaptic transmission.