A pharmacodynamic study of morphine and its glucuronide metabolites after single morphine dosing in cancer patients with pain.
Eleven morphine naïve patients with cancer-related pain were given a single dose of either intravenous morphine (n = 5) or oral morphine (n = 6). Blood sampling was performed over a 24-hr period and serial pain assessments were made using a categorical scale. Plasma samples were analyzed for morphine, morphine-6-glucuronide (M-6-G), morphine-3-glucuronide (M-3-G), and normorphine using high-performance liquid chromatography. In neither the intravenous nor oral group was there a correlation between analgesia duration and the half-lives of morphine and M-6-G. There was no correlation between the time to peak analgesia and time to peak concentration for morphine or M-6-G. There was no significant difference in absolute concentrations of M-6-G or M-3-6 nor in the ratio of M-3-G to M-6-G at peak analgesia versus relapse.
Hoffman
M
M
Department of Medicine, Long Island Jewish Medical Center, New Hyde Park, New York, USA.
Xu
J C
JC
Smith
C
C
Fanelli
C
C
Pascal
V
V
Degaetano
C
C
Meenan
G
G
Lehrer
M
M
Lesser
M
M
Citron
M
M
D000284:Administration, Oral; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000493:pharmacokinetics* / Q000627:therapeutic use; D019540:Area Under Curve; D002851:Chromatography, High Pressure Liquid; D006207:Half-Life; D006801:Humans; D007275:Injections, Intravenous; D009020:Morphine / Q000008:administration & dosage / Q000493:pharmacokinetics* / Q000627:therapeutic use; D009022:Morphine Derivatives / Q000378:metabolism*; D009369:Neoplasms / Q000150:complications / Q000188:drug therapy*; D010146:Pain / Q000188:drug therapy* / Q000209:etiology; D010147:Pain Measurement
D000701:Analgesics, Opioid; D009022:Morphine Derivatives; C035349:morphine-6-glucuronide; D009020:Morphine; C018108:morphine-3-glucuronide