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Text
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<a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11969141" target="_blank" rel="noreferrer">http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11969141</a>
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Title
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Pain, sedation and morphine metabolism in cancer patients during long-term treatment with sustained-release morphine
Publisher
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Palliative Medicine
Date
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2002
Subject
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Female; Male; Adult; Analgesics; Aged; Delayed-Action Preparations; Human; Middle Age; Neoplasms/complications/metabolism; effects/pharmacokinetics; Morphine Derivatives/blood; Morphine/administration & dosage/adverse effects/pharmacokinetics; Opioid/administration & dosage/adverse; Pain/etiology/metabolism/prevention & control
Creator
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Andersen G; Jensen NH; Christrup L; Hansen SH; Sjogren P
Description
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BACKGROUND: Morphine-6-glucuronide (M-6-G) and morphine-3-glucuronide (M-3-G) are the two most important metabolites of morphine. Both are pharmacologically active, however, with different effects. M-6-G has been demonstrated capable of inducing anti-nociception and sedation, and M-3-G may induce behavioural excitation and possibly antagonise anti-nociception. Their impact on pharmacodynamics in patients in long-term treatment with oral morphine remains to be settled. METHODS: Forty-two cancer patients treated with oral sustained-release (SR) morphine were assessed for pain, sedation and other side effects related to morphine treatment. Blood samples were analysed for morphine, M-3-G and M-6-G by high-performance liquid chromatography (HPLC). RESULTS: Significant correlations were found between the daily dose of SR morphine and plasma morphine (M) (r = 0.535, P < 0.001), plasma M-6-G (r = 0.868, P < 0.001) and plasma M-3-G (r = 0.865, P < 0.001). There was no relationship between plasma morphine, M-6-G, M-6-G/M and pain and sedation scores. Seventy-nine percent of the patients suffered from dryness of the mouth, which was the most frequent side effect observed. Patients in this group had higher plasma morphine and M-6-G concentrations than patients who did not suffer from this side effect. CONCLUSION: The plasma concentrations of morphine and its metabolites, M-3-G and M-6-G, are significantly correlated to the daily dose of SR morphine. Although M-6-G has analgesic properties, no associations were found between pain and plasma morphine and morphine metabolites. This may be due to the multitudinous factors affecting the dose-effect relationship. Patients with dryness of the mouth had higher concentrations of morphine and M-6-G than patients without this side effect.
2002
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Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Type
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Journal Article
2002
Adult
Aged
Analgesics
Andersen G
Backlog
Christrup L
Delayed-Action Preparations
effects/pharmacokinetics
Female
Hansen SH
Human
Jensen NH
Journal Article
Male
Middle Age
Morphine Derivatives/blood
Morphine/administration & dosage/adverse effects/pharmacokinetics
Neoplasms/complications/metabolism
Opioid/administration & dosage/adverse
Pain/etiology/metabolism/prevention & control
Palliative Medicine
Sjogren P