Perfusion intraveineuse prolongée de morphine. Etude pharmacocinétique

Tanguy, M.; Malledant, Yannick; Verge, Roger Le; Gibassier, D; Saint-Marc, Cécile

doi:10.1016/s0750-7658(87)80005-9

Cited by 6 publications

(2 citation statements)

References 33 publications

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“…Previous pharmacokinetic studies have been performed during continuous intravenous infusion with morphine in postoperative patients with apparently normal hepatic and renal functions (Persson et al, 1986;Tanguy et al, 1987). After correcting for the morphine blood/plasma concentration ratio of 1.1 determined in humans (Patwardhan et al, 1981), the plasma clearance values found in the present study are similar in distribution to the blood clearance values reported by Persson 1986).…”

Section: Discussionsupporting

confidence: 81%

“…After correcting for the morphine blood/plasma concentration ratio of 1.1 determined in humans (Patwardhan et al, 1981), the plasma clearance values found in the present study are similar in distribution to the blood clearance values reported by Persson 1986). However, they are approximately half the values reported by Tanguy et al (1987). The patients included in the present study had varying degrees of renal function but no overt hepatic dysfunction.…”

Section: Discussionmentioning

confidence: 46%

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The influence of renal function on the renal clearance of morphine and its glucuronide metabolites in intensive‐care patients.

Milne

Nation

Somogyi

et al. 1992

Brit J Clinical Pharma

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1. The relationships between renal creatinine clearance and the renal clearances of morphine, morphine‐3‐glucuronide (M3G) and morphine‐6‐ glucuronide (M6G) were studied in fifteen intensive‐care patients who were receiving morphine sulphate by constant intravenous infusion and who had diverse renal function. 2. An arterial blood sample was collected before and after a 4‐5 h urine collection. Plasma and urine concentrations of morphine, M3G and M6G were measured by h.p.l.c. Plasma binding of all three compounds in drug‐free plasma from healthy volunteers was determined by ultrafiltration. Measured renal creatinine clearance (CLCr, meas) was calculated from plasma and urinary creatinine concentrations (from h.p.l.c.). Also, creatinine clearance was predicted (CLCr, pred) from routine laboratory determination of plasma creatinine (Jaffe method). 3. There were significant linear relationships (P less than 0.001) between CLCr, meas and the renal clearances of morphine, M3G and M6G. The unbound renal clearance of morphine exceeded CLCr, meas (P less than 0.002) while the unbound renal clearances of M3G and M6G did not differ from CLCr, meas (P greater than 0.5). 4. In ten of the patients who received a constant infusion of morphine for at least 6 h, the dose‐normalised plasma concentrations of M3G and M6G increased with decreasing CLCr, pred. Significant (P less than 0.001) relationships were observed between the reciprocal of CLCr, pred and the dose‐normalised plasma concentrations of M3G and M6G. 5. The results indicate the importance of renal function in determining the renal clearances and plasma concentrations of M3G and M6G during intravenous infusion with morphine in intensive‐care patients.

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Section: Discussionsupporting

confidence: 81%

Section: Discussionmentioning

confidence: 46%