Renal failure and the use of morphine in intensive care.
Intravenous morphine infusions were given to 20 patients in the intensive-care unit to provide sedation and analgesia. In 10 of the patients renal impairment was already present or developed during intensive care. Plasma morphine concentrations for a given dose of morphine and morphine clearance depended on renal function; dose-related plasma morphine concentrations rose as renal function deteriorated. Reduced morphine clearance leads to increased elimination half-life of the drug, and neurological impairment caused by unrecognised high concentrations of morphine could result in an incorrect diagnosis of cerebral damage in patients in intensive care.
Ball
M
M
McQuay
H J
HJ
Moore
R A
RA
Allen
M C
MC
Fisher
A
A
Sear
J
J
D000328:Adult; D000368:Aged; D003404:Creatinine / Q000097:blood; D003422:Critical Care; D005260:Female; D006801:Humans; D007668:Kidney / Q000378:metabolism / Q000503:physiopathology*; D007674:Kidney Diseases / Q000378:metabolism* / Q000503:physiopathology; D008297:Male; D008657:Metabolic Clearance Rate; D008875:Middle Aged; D009020:Morphine / Q000378:metabolism* / Q000627:therapeutic use
D009020:Morphine; D003404:Creatinine