Serum and urine concentrations of morphine and morphine metabolites in patients with advanced cancer receiving continuous intravenous morphine: an observational study

BMC Palliative Care

Research Article

Chul-Min Kim¹  Junghan Song²  Sang-Yeon Suh³  Yong Joo Lee⁴  Sanghee Shiny Lee⁵  Hong-Yup Ahn⁵  Ah-Ram Seo⁵  Pål Klepstad⁶  Myung Ah Lee⁷ 

[1] Department of Family Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea;Department of Laboratory Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, South Korea;Department of Medicine, Dongguk University School of Medicine, 30 Pildong-ro 1-gil, Jung-gu, 100-715, Seoul, South Korea;Department of Palliative Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea;Department of Statistics, Dongguk University, Seoul, South Korea;Departments of Anaesthesiology and Intensive Care Medicine, St. Olvas University Hospital, Trondheim, Norway;Department of Circulation and Medical Imaging, Medical Faculty, Norwegian University of Technology and Science, Trondheim, Norway;Division of Oncology, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea;

关键词: Morphine;    Metabolite;    Serum;    Urine;    Monitoring;    Advanced cancer;   

DOI  :  10.1186/s12904-015-0052-9

 received in 2015-06-20, accepted in 2015-10-22,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundThe feasibility and clinical implication of drug monitoring of morphine, morphine-6-glucuronide (M6G) and morphine-3-glucuronide (M3G) need further investigation. This study aimed to determine what predicts serum concentrations of morphine in cancer patients receiving continuously intravenous morphine, the relationships between serum concentration of morphine/its metabolites and urinary concentrations, and the relation between morphine concentrations and with clinical outcomes.MethodsWe collected serum and urine samples from 24 patients with advanced cancer undergoing continuously intravenous morphine therapy. Serum samples were obtained at day one. Spot urine samples were collected once daily on three consecutive days. Pain and adverse drug events were assessed using the Korean version of MD Anderson Symptom Inventory.ResultsA total of 96 samples (72 urine and 24 serum samples) were collected. Median dose of morphine was 82.0 mg/24 h. In a multivariate analysis, total daily morphine dose was the most significant predictors of both serum and urine concentration of morphine. Morphine, M6G, and M3G in serum and urine were statistical significantly correlated (correlation coefficient = 0.81, 0.44, 0.56; p values < 0.01, 0.03, 0.01, respectively).ConclusionSpot urine concentrations of morphine and its metabolites were highly correlated to those of serum. Total dose of daily morphine was related to both serum and urine concentration of morphine and its metabolites.

【 授权许可】

CC BY   
© Lee et al. 2015