Urinary Excretion of Meperidine and its Metabolites

Yeh, S.Y.; Krebs, H.A.; Changchit, Arunee

doi:10.1002/jps.2600700808

Cited by 20 publications

(9 citation statements)

References 19 publications

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“…In fact, heroin has an extremely short life (approximately 5 min) and is rapidly deacetylated by blood esterases to 6-monoacetyl-morphine (6-MAM). 6-MAM is, in turn, hydrolyzed by liver enzymes to morphine, and is conjugated to its glucuronide metabolites (Yeh et al, 1976). Street heroin may also contain acetylcodeine, which is metabolized to codeine and, in a low percentage, to codeine glucuronide.…”

Section: Opiate Structures and Disposition In Biological Fluidsmentioning

confidence: 99%

The role of liquid chromatography-mass spectrometry in the determination of heroin and related opioids in biological fluids

Pichini

Altieri

Pellegrini

et al. 1999

Mass Spectrom. Rev.

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Section: Opiate Structures and Disposition In Biological Fluidsmentioning

confidence: 99%

The role of liquid chromatography-mass spectrometry in the determination of heroin and related opioids in biological fluids

Pichini

Altieri

Pellegrini

et al. 1999

Mass Spectrom. Rev.

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“…Meperidine is extensively metabolized in the liver by glucuronidation to normeperidine, which is in turn, renally excreted. In patients with impaired renal function, normeperidine can accumulate, and given its long half-life, can result in CNS toxicity with symptoms including tremors, myoclonus, and seizures [26]. Typical side effects of meperidine resemble those of morphine, although hypotension may be more profound after a bolus dose of meperidine.…”

Section: Meperidinementioning

confidence: 99%

Clinical review of intravenous opioids in acute care

McKeen¹,

Quraishi

2013

J Anesthesiol Clin Sci

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Opioids are routinely used in the management of moderate to severe pain. However, in the acute care setting, consistently undertreated and suboptimally managed pain continues to be a problem. Given the potential for opioids to result in lifethreatening situations, and the increasing complexity of the patients that are cared for in acute care facilities, a thorough understanding of intravenous opioid therapy is a necessity for hospital-based clinicians. Opioids can be classified by chemical structure and/or drug effect (i.e. action on Mu, Kappa, and Delta opioid receptors throughout the body). Endogenous opioids include endorphins, enkephalins, and dynorphins, which moderate the body's natural response to pain. Commonly used exogenous intravenous opioids include morphine, hydromorphone, fentanyl, meperidine, methadone, buprenorphine, butorphanol, and nalbuphine, which vary greatly in potency, duration of action, metabolism, and in their adverse effect profile. A growing body of evidence suggests that patient controlled analgesia may be superior to conventional methods (need for analgesia determined by clinicians) of treating pain in the acute care setting. Newer pump delivery systems may also decrease the risks of human and equipment errors as well as enhance patient safety and satisfaction. The purpose of this review is to help guide clinicians in the safe and effective management of pain in patients requiring intravenous opioid therapy in the acute care setting.

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“…Regressi onsgerade (n=321 (Adler et al 1955;Elliott et al 1971;Yeh 1975;Yeh et al 1976). Verschiedene Autoren halten daher eine Hydrolyse der Konjugate zur Erh6-hung der Ausbeute und Empfindlichkeit ffir unbedingt erforderlich (Geldmacher-v. Mallinckrodt 1976).…”

Section: • S~unclassified

“…80% des Codeins nicht gefunden. Es muB daher mit h6heren Sfiurekonzentrationen oder h6herer Temperatur unter Umstfinden im Autoklaven (Yeh et al 1976;Budd et al 1980;Dutt et al 1983) gearbeitet werden. Unter diesen Bedingungen werden die freien Basen allerdings bereits merklich zersetzt.…”

Section: • S~unclassified

“…B6rner und Abbott (1973) nehmen aufgrund ihrer Untersuchungen an, daB bei Opiatabhfingigen die O-Methyl-Transferase-Aktivitfit wesentlich gesteigert ist. Andererseits fanden Yeh et al (1976Yeh et al ( , 1977 nach Morphin-Gaben bei eingehenden Analysen kein Codein. Eine Erklfirungsm6g-lichkeit w/ire darin zu sehen, daB Codein als Begleitalkaloid des Morphins und damit auch des Ausgangsmaterials des Heroins nur schwer vollstfindig abtrennbar ist.…”

Section: • S~unclassified

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Methodik und Interpretation des Morphiat-Nachweises in Harnproben

1985

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In TLC screenings of 335 urine samples taken because of suspicion of heroin consumption, positive evidence of morphine was found in about 50% of the cases, which was confirmed without exception by gas chromatography-mass spectrometry. In 66% of the positive cases, morphine and codeine were found; in about 31% only morphine was found, and the median value of 0.4 mg/l free morphine and 1.0 mg/l conjugated morphine was considerably lower than in the whole collection of samples. Comparison of the codeine/morphine quotients (Q), especially the free bases, proves that the groups of heroin/morphine or codeine consumers can be distinctly differentiated. The critical conditions of the conjugated bases worked out by Dutt et al. (1983) proved to be right. Using the equation Qf less than 0.5 square root c, a boundary condition for the free flare bases can also be developed, which is dependent on the sum of the codeine and morphine concentrations and which proves heroin/morphine consumption with 98% certainty.

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Urinary Excretion of Meperidine and its Metabolites

Cited by 20 publications

References 19 publications

The role of liquid chromatography-mass spectrometry in the determination of heroin and related opioids in biological fluids

The role of liquid chromatography-mass spectrometry in the determination of heroin and related opioids in biological fluids

Clinical review of intravenous opioids in acute care

Methodik und Interpretation des Morphiat-Nachweises in Harnproben

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