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submitted by medstudied(2),

can someone explain how morphine is degraded into active metabolites that accumulate? I couldn't find any sources that state this fact. Isn't it metabolized through the P450 system and excreted in urine?

staygoodpupper  Morphine mostly undergoes phase II metabolism and is then excreted renally. Some of the metabolites are metabolically active, and her creatinine was a little elevated, so renal clearance could have been impaired. +2  


Why is the answer adenylyl cyclase? I looked in FA and I saw that GH uses the JAK2/STAT pathway and that IGF-1 uses the MAP Kinase pathway. Not sure how adenylyl cyclase plays into this.

pug_sheen  I think they are talking about the GHRH receptor on somatotrophs, which works through the cAMP pathway. +  
staygoodpupper  I don’t know how it relates to GH/IGF-1 in particular, but the question said there was a mutation in the alpha subunit of Gs, which activates adenylyl cyclase. +1  
kash1f  I agree the patient does have Acromegaly, but in the question it talked about how the patient had a mutation that prevented the GTPase activity of Gas. So Gs would be overactive --> excess adenylyl cyclase +2  
hyperfukus  ugh i was so excited too bc i thought i remembered jak stat epicfail +