A Pharmacodynamic Study of Morphine and Its Glucuronide Metabolites After Single Morphine Dosing in Cancer Patients with Pain |
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Authors: | Mark Hoffman Jing-Chu Xu Candace Smith Chris Fanelli Valda Pascal Colleen Degaetano Gerard Meenan Michael Lehrer Martin Lesser Marc Citron |
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Affiliation: | a Division of Hematology/Oncology Department of Medicine, Long Island Jewish Medical Center, New Hyde Park, New Yorkb St. John's University College of Pharmacy and Pharmacokinetic Service Long Island Jewish Medical Center,c Division of Toxicology Department of Pathology, Long Island Jewish Medical Center,d Statistical Consulting, New York |
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Abstract: | Eleven morphine naive 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 ofM-3-G to M-6-G at peak analgesia versus relapse. |
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