Abstract
We report a case of long lasting respiratory depression after intravenous administration of morphine to a 7 year old girl with haemolytic uraemic syndrome. The plasma concentrations of the active metabolite M6G were more than 10 times those normally seen and the half-lives of M6G and morphine were prolonged.
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Selected References
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- Christensen C. B., Jørgensen L. N. Morphine-6-glucuronide has high affinity for the opioid receptor. Pharmacol Toxicol. 1987 Jan;60(1):75–76. doi: 10.1111/j.1600-0773.1987.tb01724.x. [DOI] [PubMed] [Google Scholar]
- Dahlström B. E., Paalzow L. K. Pharmacokinetic interpretation of the enterohepatic recirculation and first-pass elimination of morphine in the rat. J Pharmacokinet Biopharm. 1978 Dec;6(6):505–519. doi: 10.1007/BF01062106. [DOI] [PubMed] [Google Scholar]
- Dahlström B., Tamsen A., Paalzow L., Hartvig P. Patient-controlled analgesic therapy, Part IV: pharmacokinetics and analgesic plasma concentrations of morphine. Clin Pharmacokinet. 1982 May-Jun;7(3):266–279. doi: 10.2165/00003088-198207030-00006. [DOI] [PubMed] [Google Scholar]
- Don H. F., Dieppa R. A., Taylor P. Narcotic analgesics in anuric patients. Anesthesiology. 1975 Jun;42(6):745–747. doi: 10.1097/00000542-197506000-00021. [DOI] [PubMed] [Google Scholar]
- Fisher A. P., Hanna M., Rhodes S. P. Spinal level analgesia after morphine overdose? Lancet. 1987 Mar 7;1(8532):573–573. doi: 10.1016/s0140-6736(87)90223-6. [DOI] [PubMed] [Google Scholar]
- Hand C. W., Blunnie W. P., Claffey L. P., McShane A. J., McQuay H. J., Moore R. A. Potential analgesic contribution from morphine-6-glucuronide in CSF. Lancet. 1987 Nov 21;2(8569):1207–1208. doi: 10.1016/s0140-6736(87)91341-9. [DOI] [PubMed] [Google Scholar]
- Hanks G. W., Hoskin P. J., Aherne G. W., Chapman D., Turner P., Poulain P. Enterohepatic circulation of morphine. Lancet. 1988 Feb 27;1(8583):469–469. doi: 10.1016/s0140-6736(88)91256-1. [DOI] [PubMed] [Google Scholar]
- Hochman M. S. Meperidine-associated myoclonus and seizures in long-term hemodialysis patients. Ann Neurol. 1983 Nov;14(5):593–593. doi: 10.1002/ana.410140520. [DOI] [PubMed] [Google Scholar]
- Jacqz E., Ward S., Johnson R., Schenker S., Gerkens J., Branch R. A. Extrahepatic glucuronidation of morphine in the dog. Drug Metab Dispos. 1986 Nov-Dec;14(6):627–630. [PubMed] [Google Scholar]
- Lynn A. M., Slattery J. T. Morphine pharmacokinetics in early infancy. Anesthesiology. 1987 Feb;66(2):136–139. doi: 10.1097/00000542-198702000-00005. [DOI] [PubMed] [Google Scholar]
- Oguri K., Yamada-Mori I., Shigezane J., Hirano T., Yoshimura H. Enhanced binding of morphine and nalorphine to opioid delta receptor by glucuronate and sulfate conjugations at the 6-position. Life Sci. 1987 Sep 21;41(12):1457–1464. doi: 10.1016/0024-3205(87)90710-7. [DOI] [PubMed] [Google Scholar]
- Osborne R. J., Joel S. P., Slevin M. L. Morphine intoxication in renal failure: the role of morphine-6-glucuronide. Br Med J (Clin Res Ed) 1986 Jun 14;292(6535):1548–1549. doi: 10.1136/bmj.292.6535.1548. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Osborne R., Joel S., Trew D., Slevin M. Analgesic activity of morphine-6-glucuronide. Lancet. 1988 Apr 9;1(8589):828–828. doi: 10.1016/s0140-6736(88)91691-1. [DOI] [PubMed] [Google Scholar]
- Pasternak G. W., Bodnar R. J., Clark J. A., Inturrisi C. E. Morphine-6-glucuronide, a potent mu agonist. Life Sci. 1987 Dec 28;41(26):2845–2849. doi: 10.1016/0024-3205(87)90431-0. [DOI] [PubMed] [Google Scholar]
- Petters I., Peng D. R., Rane A. Quantitation of clonazepam and its 7-amino and 7-acetamido metabolites in plasma by high-performance liquid chromatography. J Chromatogr. 1984 Mar 9;306:241–248. doi: 10.1016/s0378-4347(00)80886-5. [DOI] [PubMed] [Google Scholar]
- Shimomura K., Kamata O., Ueki S., Ida S., Oguri K. Analgesic effect of morphine glucuronides. Tohoku J Exp Med. 1971 Sep;105(1):45–52. doi: 10.1620/tjem.105.45. [DOI] [PubMed] [Google Scholar]
- Svensson J. O., Rane A., Säwe J., Sjöqvist F. Determination of morphine, morphine-3-glucuronide and (tentatively) morphine-6-glucuronide in plasma and urine using ion-pair high-performance liquid chromatography. J Chromatogr. 1982 Jul 9;230(2):427–432. doi: 10.1016/s0378-4347(00)80494-6. [DOI] [PubMed] [Google Scholar]
- Szeto H. H., Inturrisi C. E., Houde R., Saal S., Cheigh J., Reidenberg M. M. Accumulation of normeperidine, an active metabolite of meperidine, in patients with renal failure of cancer. Ann Intern Med. 1977 Jun;86(6):738–741. doi: 10.7326/0003-4819-86-6-738. [DOI] [PubMed] [Google Scholar]
- Säwe J., Dahlström B., Rane A. Steady-state kinetics and analgesic effect of oral morphine in cancer patients. Eur J Clin Pharmacol. 1983;24(4):537–542. doi: 10.1007/BF00609900. [DOI] [PubMed] [Google Scholar]
- Säwe J., Odar-Cederlöf I. Kinetics of morphine in patients with renal failure. Eur J Clin Pharmacol. 1987;32(4):377–382. doi: 10.1007/BF00543973. [DOI] [PubMed] [Google Scholar]
- Säwe J., Svensson J. O., Odar-Cederlöf I. Kinetics of morphine in patients with renal failure. Lancet. 1985 Jul 27;2(8448):211–211. doi: 10.1016/s0140-6736(85)91520-x. [DOI] [PubMed] [Google Scholar]
- Woolner D. F., Winter D., Frendin T. J., Begg E. J., Lynn K. L., Wright G. J. Renal failure does not impair the metabolism of morphine. Br J Clin Pharmacol. 1986 Jul;22(1):55–59. doi: 10.1111/j.1365-2125.1986.tb02880.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
