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Original Article

Clinical Pharmacokinetics of Morphine

(Research Assistant Professor) (Assistant Professor) (Coordinator of Clinical Education) (Adjunct Associate Professor) (Associate Professor) (Research Assistant Professor) (Assistant Professor) (Coordinator of Clinical Education) (Adjunct Associate Professor) (Associate Professor) (Research Assistant Professor) (Assistant Professor) (Coordinator of Clinical Education) (Adjunct Associate Professor) (Associate Professor) (Research Assistant Professor) (Assistant Professor) (Coordinator of Clinical Education) (Adjunct Associate Professor) (Associate Professor) (Research Assistant Professor) (Assistant Professor) (Coordinator of Clinical Education) (Adjunct Associate Professor) (Associate Professor) &
Pages 5-18 | Received 24 Apr 2002, Accepted 07 Jun 2002, Published online: 17 Aug 2009

References

  • Glare P A, Walsh T D. Clinical Pharmacokinetics of Morphine. Therapeutic Drug Monitoring 1991; 13: 1–23
  • Dahlstrom B, Bolme P, Feychting H, Noack G, Paalzow L. Morphine kinetics in children. Clin Pharmacol Ther 1979; 26: 354–365
  • Sawe J, Dahlstrom B, Paalzow L, Rane A. Morphine kinetics in cancer patients. Clin Pharmacol Ther 1981; 30: 629–635
  • Sawe J, Svensson J O, Rane A. Morphine metabolism in cancer patients on increasing oral dosesno evidence for autoinduction or dose-dependence. Br J Clin Pharmacol 1983; 16: 85–93
  • Osborne R, Joel S, Trew D, Sleven M. Morphine and metabolite behavior after different routes of administration: demonstration of the importance of the active metabolite morphine-6-glucuronide. Clin Pharmacol Ther 1990; 47: 12–19
  • Sawe J. High dose morphine and methadone in cancer patients. Clinical pharmacokinetic considerations or oral treatment. Clin Pharmacokinet 1986; 11: 87–106
  • McQuay H J, Carrol l D, Faura C C, Gavaghan D J, Hand C W, Moore R A. Oral morphine in cancer pain: influences on morphine and metabolite concentration. Clin Pharmacol Ther 1990; 48: 236–244
  • Stanski D R, Greenblatt D J, Lowenstein E. Kinetics of intravenous and intramuscular morphine. Clin Pharmacol Ther 1978; 24: 52–59
  • Brunk F, Delle M. Morphine metabolism in man. Clin Pharmacol Ther 1974; 16: 51–57
  • Waldmann C S, Eason J R, Rambohul E, Hanson G C. Serum morphine levels. A comparison between continuous subcutaneous infusion and continuous intravenous infusion in postoperative patients. Anaesthesia 1984; 39: 768–771
  • Laitinen L, Kanto J, Vapaavuori M, Viljanen M. Morphine concentrations in plasma after intramuscular administration. Br J Anaesth 1975; 47: 1265–1267
  • Stuart-Harris R, Joel S P, McDonald P, Currow D, Slevin M L. The pharmacokinetics of morphine and morphine glucuronide metabolites after subcutaneous bolus injection and subcutaneous infusion of morphine. Br J Clin Pharmacol 2000; 49: 207–214
  • Mikkelsen Lynch P, Butler J, Huerta D, Tsals I, Davidson D, Hamm S. A pharmacokinetic and tolerability evaluation of two continuous subcutaneous infusion systems compared to an oral controlled-release morphine. J Pain Symptom Manage 1991; 6: 431–436
  • Vermeire A, Remon J P, Rosseel M T, Belpaire F, Devulder J, Bogaert M G. Variability of morphine disposition during long-term subcutaneous infusion in terminally ill cancer patients. Eur J Clin Pharmacol Jan, 1998; 53(5)325–30
  • Shvartzman P, Bonneh D. Local skin irritation in the course of subcutaneous morphine infusion: a challenge. J Palliat Care 1994; 10: 44–45
  • Cousins M, Mather L. Intrathecal and epidural administration of opioids. Anesthesiology 1984; 61: 276–310
  • Drug Facts and Comparisons. Facts and Comparisons, St. Louis 2002
  • McQuay H, Sullivan A, Smallman K, Dickenson A. Intrathecal opioids, potency and lipophilicity. Pain 1989; 36: 111–115
  • Bailey P, Rhondeau S, Schafer P, et al. Dose-response pharmacology of intrathecal morphine in human volunteers. Anesthesiology 1993; 49–59
  • Bailey P, Lu J, Pace N, et al. Effects of intrathecal morphine on the ventilatory response to hypoxia. N Eng J Med 2000; 343: 1228–1234
  • Hoskin P J, Hanks G W, Aherne G W, Chapman D, Littleton P, Filshie J. The bioavailability and pharmacokinetics of morphine after intravenous, oral, and buccal administration in healthy volunteers. Br J Clin Pharmacol 1989; 27: 499–505
  • Gourlay G K, Cherry D A, Cousins M J. A comparative study of the efficacy and pharmacokinetics of oral methadone and morphine in the treatment of severe pain in patients with cancer. Pain 1986; 25: 297–312
  • Gourlay G K, Plummer J L, Cherry D A. Chronopharmacokinetic variability in plasma morphine concentrations following oral doses of morphine solution. Pain 1995; 61: 375–381
  • Hanks G W, Hoskin P J, Aherne G W, Turner P, Poulain P. Explanation for potency of repeated oral doses of morphine?. Lancet 1987; 26(2)723–725, (8561)
  • Hanks G W. Morphine pharmacokinetics and analgesia after oral administration. Postgrad Med J 1991; 67(Suppl 2)S60–63
  • Lotsch J, Weiss M, Ahne G, Kobal G, Geisslinger G. Pharmacokinetic modeling of M6G formation after oral administration of morphine in healthy volunteers. Anesthesiology 1999; 90: 1026–1038
  • Khojasteh A, Evans W, Reynolds R D, Thomas G, Savarese J J. Controlled-release oral morphine sulfate in the treatment of cancer pain with pharmacokinetic correlation. J Clin Oncol 1987; 5: 956–961
  • Savarese J J, Goldenheim P D, Thomas G B, Kaiko R F. Steady state pharmacokinetics of controlled release oral morphine sulfate in healthy subjects. Clin Pharmcokinet 1986; 11: 505–510
  • Vater M, Smith G, Aherne G W, Aitkenhead A R. Pharmacokinetics and analgesic effects of slow-release oral morphine sulphate in volunteers. Br J Anaesth 1984; 56: 821–827
  • Gourlay G K, Plummer J L, Cherry D A, Purser T. The reproducibility of bioavailability of oral morphine from solution under fed and fasted conditions. J Pain Symptom Manage Oct, 1991; 6(7)431–436
  • Gourlay G K, Plummer J L, Cherry D A, Foate J A, Cousins M J. Influence of a high-fat meal on the absorption of morphine from oral solutions. Clin Pharmacol Ther 1989; 46: 463–468
  • Kaiko R F, Lazarus H, Cronin C, Grandy R, Thomas G, Goldenheim P. Controlled-release morphine bioavailability (MS Contin tablets) in the presence and absence of food. Hosp J 1990; 6: 17–30
  • Coluzzi P H. Sublingual morphine: efficacy reviewed. J Pain Symptom Manage 1998; 16: 184–192
  • Davis T, Miser A W, Loprinzi C L, et al. Comparative morphine pharmacokinetics following sublingual, intramuscular, and oral administration in patients with cancer. Hosp J 1993; 9: 85–90
  • Fisher A P, Vine P, Whitlock J, Hanna M. Buccal morphine premedication. A double-blind comparison with intramuscular morphine. Anaesthesia 1986; 41: 1104–1111
  • Bell M D, Murray G R, Mishra P, Calvey T N, Weldon B D, Williams N E. Buccal morphine-a new route for analgesia?. Lancet 1985; 1: 71–73
  • Westerling D, Lindahl S, Andersson K E, Andersson A. Absorption and bioavailability of rectally administered morphine in women. Eur J Clin Pharmacol 1982; 23: 59–64
  • Du X, Skopp G, Aderjan R. The influence of the route of administration: a comparative study at steady state of oral sustained release morphine and morphine sulfate suppositories. Ther Drug Monit 1999; 21: 208–214
  • Jonsson T, Christensen C B, Jordening H, Frolund C. The bioavailability of rectally administered morphine. Pharmacol Toxicol 1988; 62: 203–205
  • Ellison N M, Lewis G O. Plasma concentrations following single doses of morphine sulfate in oral solution and rectal suppository. Clin Pharm 1984; 3: 614–617
  • Babul N, Darke A C, Anslow J A, Krishnamurthy T N. Pharmacokinetics of two novel rectal controlled-release morphine formulations. J Pain Symptom Manage Oct, 1991; 6(7)431–436
  • Moolenar F, Leuverman A, Schoonen B JM. Bioavailability of morphine from suppositories. Int J Pharm 1988; 45: 161–164
  • Lipman A G. Drug therapy in terminally ill patients. Am J Hosp Pharm 1975; 32: 270–276
  • Lipman A G, Anderson B D. Bioavailability of morphine from rectal suppositories. Am J Hosp Pharm 1984; 41: 636
  • Dahlstrom B, Tamsen A, Paalzow L, Hartvig P. Patient-controlled analgesic therapy, Part IV: pharmacokinetics and analgesic plasma concentrations of morphine. Clin Pharmacokinet 1982; 7: 266–279
  • Owen J A, Sitar D S, Berger L, Brownell L, Duke P C, Mitenko P A. Age-related morphine kinetics. Clin Pharmacol Ther 1983; 34: 364–368
  • Olsen G D. Morphine binding to human plasma proteins. Clin Pharmacol Ther 1975; 17: 31–35
  • Spector S, Vesell E S. Disposition of morphine in man. Science 1971; 174: 421–422
  • Yeh S Y, Gorodetzky C W, Krebs H A. Isolation and identification of morphine 3-and 6-glucuronides, morphine 3,6-diglucuronide, morphine 3-ethereal sulfate, normorphine, and normorphine 6-glucuronide as morphine metabolites in humans. J Pharm Sci 1977; 66: 1288–1293
  • Sawe J, Kager L, Svensson J O, Rane A. Oral morphine in cancer patients: in vivo kinetics and in vitro hepatic glucuronidation. Br J Clin Pharmacol 1985; 19: 495–501
  • Wolff T, Samuelsson H, Hedner T. Morphine and morphine metabolite concentrations in cerebrospinal fluid and plasma in cancer pain patients after slow-release oral morphine administration. Pain 1995; 62: 147–154
  • Smith M T, Watt J A, Cramond T. Morphine-3-glucuronide-a potent antagonist of morphine analgesia. Life Sci 1990; 47: 579–585
  • Gong Q L, Hedner J, Bjorkman R, Hedner T. Morphine-3-glucuronide may functionally antagonize morphine-6-glucuronide induced antinociception and ventilatory depression in the rat. Pain 1992; 48: 249–255
  • Faura C C, Collins S L, Moore R A, McQuay H J. Systematic review of factors affecting the ratios of morphine and its major metabolites. Pain 1998; 74: 43–53
  • Christrup L L. Morphine metabolites. Acta Anasthesiol Scand 1997; 41: 116–122
  • Smith M T. Neuroexcitatory effects of morphine and hydromorphone: evidence implicating the 3-glucuronide metabolites. Clin Exp Pharmacol Physiol 2000; 27: 524–528
  • Sullivan A F, McQuay H J, Bailey D, Dickenson A H. The spinal antinociceptive actions of morphine metabolites morphine-6-glucuronide and normorphine in the rat. Brain Res 1989; 482: 219–224
  • Chen Z R, Irvine R J, Somogyi A A, Bochner F. Mu receptor binding of some commonly used opioids and their metabolites. Life Sci 1991; 48: 2165–2171
  • Shimomura K, Kamata O, Ueki S, Ida S, Oguri K. Analgesic effect of morphine glucuronides. Tohoku J Exp Med 1971; 105: 45–52
  • Lotsch J, Stockmann A, Kobal G, et al. Pharmacokinetics of morphine and its glucuronides after intravenous infusion of morphine and morphine-6-glucuronide in healthy volunteers. Clin Pharmacol Ther 1996; 60: 316–325
  • Peat S J, Hanna M H, Woodham M, Knibb A A, Ponte J. Morphine-6-glucuronide: effects on ventilation in normal volunteers. Pain 1991; 45: 101–104
  • Sawe J, Odar-Cederlof I. Kinetics of morphine in patients with renal failure. Eur J Clin Pharmacol 1987; 32: 377–382
  • Sawe J, Svensson J O, Odar-Cederlof I. Kinetics of morphine in patients with renal failure. Lancet 1985; 2: 211, 1985
  • Salter W, White M L. Morphine sensitivity. Anesthesiology 1949; 10: 553–561
  • Baillie S P, Bateman D N, Coates P E, Woodhouse K W. Age and the pharmacokinetics of morphine. Age Ageing 1989; 18: 258–262
  • Kart T, Christrup L L, Rasmussen M. Recommended use of morphine in neonates, infants and children based on a literature review: Part 1-Pharmacokinetics. Paediatr Anaesth 1997; 7(1)5–11, 1997, 7, 5–11
  • Lynn A M, Nespeca M K, Bratton S L, Shen D D. Intravenous morphine in postoperative infants: intermittent bolus dosing versus targeted continuous infusions. Pain 2000; 88: 89–95
  • Nahata M C, Miser A W, Miser J S, Reuning R H. Variation in morphine pharmacokinetics in children with cancer. Dev Pharmacol Ther 1985; 8: 182–188
  • Kart T, Christrup L L, Rasmussen M. Recommended use of morphine in neonates, infants and children based on a literature review: Part 2-Clinical use. Paediatr Anaesth 1997; 7: 93–101
  • Don H F, Dieppa R A, Taylor P. Narcotic analgesics in anuric patients. Anesthesiology 1975; 42: 745–747
  • Aitkenhead A R, Vater M, Achola K, Cooper C M, Smith G. Pharmacokinetics of single-dose i.v. morphine in normal volunteers and patients with end-stage renal failure. Br J Anaesth 1984; 56: 813–819
  • Woolner D F, Winter D, Frendin T J, Begg E J, Lynn K L, Wright G J. Renal failure does not impair the metabolism of morphine. Br J Clin Pharmacol 1986; 22: 55–59
  • Osborne R J, Joel S P, Slevin M L. Morphine intoxication in renal failure: the role of morphine-6-glucuronide. Br Med J (Clin Res Ed) 1986; 292: 1548–1549
  • Hasselstrom J, Eriksson S, Persson A, Rane A, Svensson J O, Sawe J. The metabolism and bioavailability of morphine in patients with severe liver cirrhosis. Br J Clin Pharmacol 1990; 29: 289–297
  • Mazoit J X, Sandouk P, Zetlaoui P, Scherrmann J M. Pharmacokinetics of unchanged morphine in normal and cirrhotic subjects. Anesth Analg 1987; 66: 293–298
  • Berkenstadt H, Segal E, Mayan H, et al. The pharmacokinetics of morphine and lidocaine in critically ill patients. Intensive Care Med 1999; 25: 110–112
  • Manara A R, Shelly M P, Quinn K, Park G R. The effect of metoclopramide on the absorption of oral controlled release morphine. Br J Clin Pharmacol 1988; 25: 518–521
  • Fromm M F, Eckhardt K, Li S, et al. Loss of analgesic effect of morphine due to coadministration of rifampin. Pain Aug, 1997; 72(1–2)261–7
  • Aasmundstad T, Storset P. Influence of ranitidine on the morphine-3-glucuronide to morphine-6-glucuronide ratio after oral administration of morphine in humans. Human Exp Toxicol 1998; 17: 347–352
  • Kest B, Sarton E, Dahan A. Gender differences in opioid-mediated analgesia: animal and human studies. Anesthesiology 2000; 93: 539–547
  • DRUGDEX Editorial Staff. Narcotic Analgesics-Equianalgesic Doses and Pharmacokinetic Comparison: Micromedex. 2002

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