title: Hepatic extraction of morphine is impaired in cirrhosis.
abstract: Using hepatic vein catheterization this study has provided the first direct measurement of morphine hepatic extraction in 8 controls and 8 cirrhotics. The extraction ratio was 0.52 in the control group and was reduced by 25% in the cirrhotics. This reduction is due to impaired enzyme capacity rather than reduced blood flow. The effect of cirrhosis is less than that reported in similar studies of high clearance oxidized drugs and this lends support to the concept that glucuronidation may be relatively spared in cirrhosis. A discrepancy between the systemic clearance and the hepatic clearance provides indirect support for extra-hepatic metabolism of morphine.
authors.affiliation: Department of Gastroenterology, St. Vincent's Hospital, Fitzroy, Victoria, Australia.
authors.forename: B
authors.initials: B
authors.lastname: Crotty
authors.forename: K J
authors.initials: KJ
authors.lastname: Watson
authors.forename: P V
authors.initials: PV
authors.lastname: Desmond
authors.forename: M L
authors.initials: ML
authors.lastname: Mashford
authors.forename: L J
authors.initials: LJ
authors.lastname: Wood
authors.forename: J
authors.initials: J
authors.lastname: Colman
authors.forename: F J
authors.initials: FJ
authors.lastname: Dudley
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007208:Indocyanine Green; D008099:Liver / Q000378:metabolism*; D008102:Liver Circulation; D008103:Liver Cirrhosis / Q000378:metabolism*; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000378:metabolism*
chemical_list: D009020:Morphine; D007208:Indocyanine Green