CHRONIC NAUSEA AND MORPHINE-6-GLUCURONIDE

被引：80

作者：

HAGEN, NA ^{[1
]}

FOLEY, KM ^{[1
]}

CERBONE, DJ ^{[1
]}

PORTENOY, RK ^{[1
]}

INTURRISI, CE ^{[1
]}

机构：

[1] CORNELL UNIV,MED CTR,COLL MED,DEPT PHARMACOL,1300 YORK AVE,NEW YORK,NY 10021

来源：

JOURNAL OF PAIN AND SYMPTOM MANAGEMENT | 1991年 / 6卷 / 03期

关键词：

MORPHINE; MORPHINE-6-GLUCURONIDE; OPIOIDS; CANCER PAIN;

D O I：

10.1016/0885-3924(91)90961-3

中图分类号：

R19 [保健组织与事业（卫生事业管理）];

学科分类号：

摘要：

Morphine-6-glucuronide is an active metabolite of morphine that has analgesic properties and is measurable in the plasma and cerebrospinal fluid of patients treated with this opioid. Decreased clearance of the compound has been observed in patients with renal insufficiency, and this has been associated with an increase in the ratio of morphine-6-glucuronide to morphine. Clinical effects from accumulation of morphine-6-glucuronide have not been described with the exception of case reports in which patients with renal failure were noted to develop opioid toxicity with high plasma levels of the metabolite and low levels of the parent drug. We describe a patient who experienced chronic nausea and an episode of confusion while treated with a small, stable dose of oral morphine in the setting of mild renal insufficiency. Relatively high levels of morphine-6-glucuronide were measured and all symptoms resolved promptly as the concentration of this metabolite declined. This case provides suggestive evidence that morphine-6-glucuronide can produce clinically significant effects in patients with mild renal insufficiency.

引用

页码：125 / 128

页数：4

共 7 条

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