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Neuropharmacology Nov 1976
Topics: Animals; Electric Stimulation; Guinea Pigs; In Vitro Techniques; Membrane Potentials; Morphine; Morphine Derivatives; Myenteric Plexus; Naloxone; Neurons; Time Factors
PubMed: 1004695
DOI: 10.1016/0028-3908(76)90043-5 -
Molecular Medicine (Cambridge, Mass.) Dec 2012Opioid-induced hyperalgesia (OIH) is a paradoxical increase in pain perception that may manifest during opioid treatment. For morphine, the metabolite...
Opioid-induced hyperalgesia (OIH) is a paradoxical increase in pain perception that may manifest during opioid treatment. For morphine, the metabolite morphine-3-glucuronide (M3G) is commonly believed to underlie this phenomenon. Here, in three separate studies, we empirically assess the role of M3G in morphine-induced hyperalgesia. In the first study, CD-1 mice injected with morphine (15 mg/kg subcutaneously) after pretreatment with the opioid receptor antagonist naltrexone (NTX) (15 mg/kg) showed tail withdrawal latency reductions indicative of hyperalgesia (2.5 ± 0.1 s at t = 30 min, P < 0.001 versus baseline). In these mice, the morphine/M3G concentration ratios versus effect showed a negative correlation (r(p) = -0.65, P < 0.001), indicating that higher morphine relative to M3G concentrations are associated with increased OIH. In the second study, similar hyperalgesic responses were observed in mice lacking the multidrug resistance protein 3 (MRP3) transporter protein (Mrp3(-/-) mice) in the liver and their wild-type controls (FVB mice; latency reductions: 3.1 ± 0.2 s at t = 30 min, P < 0.001 versus within-strain baseline). In the final study, the pharmacokinetics of morphine and M3G were measured in Mrp3(-/-) and FVB mice. Mrp3(-/-) mice displayed a significantly reduced capacity to export M3G into the systemic circulation, with plasma M3G concentrations just 7% of those observed in FVB controls. The data confirm previous literature that morphine causes hyperalgesia in the absence of opioid receptor activation but also indicate that this hyperalgesia may occur without a significant contribution of hepatic M3G. The relevance of these data to humans has yet to be demonstrated.
Topics: Animals; Hyperalgesia; Male; Mice; Morphine; Morphine Derivatives; Naltrexone; Reaction Time; Receptors, Opioid, mu
PubMed: 23001479
DOI: 10.2119/molmed.2012.00244 -
British Journal of Anaesthesia Nov 1988The bioavailability of oral controlled release morphine tablets (MST, Napp Laboratories) and oral morphine sulphate in aqueous solution (MSS) was compared in 10 patients...
The bioavailability of oral controlled release morphine tablets (MST, Napp Laboratories) and oral morphine sulphate in aqueous solution (MSS) was compared in 10 patients with advanced cancer. Serum samples were analysed for morphine, morphine-3-glucuronide (M3G) and morphine-6-glucuronide (M6G) using a specific HPLC assay. The relative bioavailability of morphine with MST was significantly less than that with MSS (mean 80%, range 50-110%) although there was no difference between the formulations in the relative availability of M3G and M6G. There was no significant difference between the formulations in the serum concentration of morphine at 12 h. The mean ratios morphine: M6G:M3G (comparing areas under the serum concentration-time curves) were 1:9:56. There was a highly significant linear relationship between the dose administered and AUC for morphine, M3G and M6G after MSS; and for morphine after MST. Median tmax for morphine was 0.5 h with MSS and 2.5 h with MST; for M3G 1.5 h with MSS and 3.0 h with MST; and for M6G 1.5 h with MSS and 3.25 h with MST. A secondary peak of unconjugated morphine, which may represent enterohepatic circulation, was seen in several patients 2-4 h after administration of elixir and 4-6 h after administration of MST.
Topics: Adult; Aged; Biological Availability; Delayed-Action Preparations; Female; Humans; Male; Middle Aged; Morphine; Morphine Derivatives; Neoplasms; Pain, Intractable
PubMed: 3207527
DOI: 10.1093/bja/61.5.569 -
Human & Experimental Toxicology Sep 2011Morphine-6-glucuronide, the active metabolite of morphine, and to a lesser extent morphine itself are known to accumulate in patients with renal failure. A number of...
Morphine-6-glucuronide, the active metabolite of morphine, and to a lesser extent morphine itself are known to accumulate in patients with renal failure. A number of cases on non-lethal morphine toxicity in patients with renal impairment report high plasma concentrations of morphine-6-glucuronide, suggesting that this metabolite achieves sufficiently high brain concentrations to cause long-lasting respiratory depression, despite its poor central nervous system penetration. We report a lethal morphine intoxication in a 61-year-old man with sickle cell disease and renal impairment, and we measured concentrations of morphine and morphine-6-glucuronide in blood, brain and cerebrospinal fluid. There were no measurable concentrations of morphine-6-glucuronide in cerebrospinal fluid or brain tissue, despite high blood concentrations. In contrast, the relatively high morphine concentration in the brain suggests that morphine itself was responsible for the cardiorespiratory arrest in this patient. Given the fatal outcome, we recommend to avoid repeated or continuous morphine administration in renal failure.
Topics: Anemia, Sickle Cell; Brain; Fatal Outcome; Heart Arrest; Humans; Male; Middle Aged; Morphine; Morphine Derivatives; Renal Insufficiency
PubMed: 21056950
DOI: 10.1177/0960327110388962 -
The Journal of Pharmacy and Pharmacology Dec 1996A pharmacokinetic study was undertaken to compare the pharmacokinetics of morphine after an intravenous dose with the pharmacokinetics after a sublingual dose...
A pharmacokinetic study was undertaken to compare the pharmacokinetics of morphine after an intravenous dose with the pharmacokinetics after a sublingual dose administered from an aerosol. Plasma levels of morphine, morphine-3-glucuronide and morphine-6-glucuronide were measured in five normal volunteers after morphine administration by the intravenous route and from a novel sublingual pressurized aerosol formulation. The mean (+/- s.d.) bioavailability of the sublingual aerosol morphine was 19.7 +/- 6.7%. The morphine-3-glucuronide/morphine and the morphine-6-glucuronide/morphine ratios were 5.1 +/- 1.6 and 1.2 +/- 0.4, respectively, for the intravenous route and 28.3 +/- 11.3 and 5.2 +/- 1.4, respectively, for the sublingual route. The combined total areas under the plots of systemic concentration against time (AUC) for the metabolites after the two routes was not significantly different. When compared with published data for oral administration the results demonstrate that the sublingual aerosol morphine might provide an alternative to conventional methods of morphine delivery, and has similar pharmacokinetics to a sublingual morphine tablet. It has no particular pharmacokinetic advantages over oral morphine, except a potential for a faster onset of analgesia. Bioavailability, maximum plasma concentration, Cpmax, and the time at which the maximum plasma concentration is reached, Tmax, are equivalent to those for orally administered morphine.
Topics: Administration, Sublingual; Adult; Aerosols; Analgesics, Opioid; Female; Humans; Male; Morphine; Morphine Derivatives
PubMed: 9004187
DOI: 10.1111/j.2042-7158.1996.tb03932.x -
Journal of Separation Science Feb 2012The aim of this work was to synthesize morphine-3-O-sulfate and morphine-6-O-sulfate for use as reference substances, and to determine the sulfate conjugates as possible...
The aim of this work was to synthesize morphine-3-O-sulfate and morphine-6-O-sulfate for use as reference substances, and to determine the sulfate conjugates as possible heroin and morphine metabolites in plasma and urine by a validated LC-MS/MS method. Morphine-6-O-sulfate and morphine-3-O-sulfate were prepared as dihydrates from morphine hydrochloride, in overall yields of 41 and 39% with product purities of >99.5% and >98%, respectively. For bioanalysis, the chromatographic system consisted of a reversed-phase column and gradient elution. The tandem mass spectrometer was operated in the positive electrospray mode using selected reaction monitoring, of transition m/z 366.15 to 286.40. The measuring range was 5-500 ng/mL for morphine-3-O-sulfate and 4.5-454 ng/mL for morphine-6-O-sulfate in plasma. In urine, the measuring range was 50-5000 ng/mL for morphine-3-O-sulfate and 45.4-4544 ng/mL for morphine-6-O-sulfate. The intra-assay and total imprecision (coefficient of variation) was below 11% for both analytes in urine and plasma. Quantifiable levels of morphine-3-O-sulfate in authentic urine and plasma samples were found. Only one authentic urine sample contained a detectable level of morphine-6-O-sulfate, while no detectable morphine-6-O-sulfate was found in plasma samples.
Topics: Chromatography, High Pressure Liquid; Crystallography, X-Ray; Humans; Models, Molecular; Morphine; Morphine Derivatives; Sensitivity and Specificity; Tandem Mass Spectrometry
PubMed: 22258807
DOI: 10.1002/jssc.201100739 -
Acta Anaesthesiologica Scandinavica Apr 1996There is limited knowledge about the pharmacokinetics of morphine and its metabolites after rectal administration in children. In this study the pharmacokinetics of two... (Clinical Trial)
Clinical Trial Randomized Controlled Trial
BACKGROUND
There is limited knowledge about the pharmacokinetics of morphine and its metabolites after rectal administration in children. In this study the pharmacokinetics of two different rectal formulations of morphine were examined and compared with intravenous morphine.
METHODS
Children undergoing elective surgery received rectal morphine 0.2 mg/kg before start of surgery. Ten children (mean age 14 months) received morphine rectally in a hydrogel formulation and another 10 children (mean age 16 months) received morphine rectally in a parenteral formulation. For comparison, 6 children (mean age 21 months) were given the same dose intravenously. The plasma concentrations of morphine, morphine-3-glucuronide (M3G) and morphine-6-glucuronide (M6G) were measured by HPLC over 6 h after drug administration.
RESULTS
The mean rectal bioavailability of morphine was 35% (range 18-59) after hydrogel administration and 27% (range 6-93) after the solution. Mean values of Cmax were 76 nmol/l (25-129) and 56 nmol/1 (15-140), respectively. The results showed that morphine gel had a significantly higher bioavailability (P < 0.02) than the solution. The ratios of plasma (M3G + M6G) to morphine were higher after rectal administration (mean 7.5-8.7) than after i.v. injection (mean 5.3), indicating the presence of first-pass metabolism using the rectal route.
CONCLUSIONS
The rectal morphine hydrogel has pharmacokinetic properties which makes it a useful formulation for premedication and pain alleviation in paediatric patients.
Topics: Administration, Rectal; Analgesics, Opioid; Child, Preschool; Humans; Infant; Morphine; Morphine Derivatives
PubMed: 8738689
DOI: 10.1111/j.1399-6576.1996.tb04467.x -
The Journal of Pharmacology and... Nov 1996Morphine injected s.c. in the tail is a potent analgesic in the tail-flick assay when the radiant heat source is focused directly over the injection site (ED50, 4.5...
Morphine injected s.c. in the tail is a potent analgesic in the tail-flick assay when the radiant heat source is focused directly over the injection site (ED50, 4.5 micrograms), but not if the radiant heat source is moved 1 cm proximally or distally to the injection site. Naloxone given systemically reverses this peripheral analgesia. Antisense oligodeoxynucleotides directed against exons 1 and 4 of MOR-1, a cloned mu opioid receptor, administered intrathecally (i.t.) block the local analgesic effect of morphine in the tail, indicating that the local response is mediated through mu receptors located on the terminals of sensory neurons from the dorsal root ganglia. Combinations of morphine given locally in the tail and spinally (i.t.) are synergistic. Spinal morphine also synergizes with systemic morphine in analgesia assays. Supraspinal morphine enhances systemic morphine analgesia, but less dramatically. We also examined tolerance on these analgesic systems by using a daily morphine injection paradigm which shifts the dose-response curve for systemic morphine approximately 2-fold after 5 days. In this paradigm, morphine's analgesic potency after either supraspinal or spinal administration alone does not change. However, the dose-response curve for local morphine in the tail is shifted by over 19-fold. The analgesic activity of the combination of supraspinal and systemic morphine is lowered approximately 2-fold and the combination of i.t. and systemic morphine by 12-fold. These studies confirm the presence of a peripheral mechanism for morphine analgesia mediated by mu receptors located on sensory neurons from the dorsal root ganglia, which is extremely sensitive to chronic morphine dosing.
Topics: Analgesia; Analgesics, Opioid; Animals; Drug Tolerance; Injections, Intraventricular; Injections, Spinal; Injections, Subcutaneous; Male; Mice; Morphine; Morphine Derivatives; Naloxone
PubMed: 8930151
DOI: No ID Found -
Drug Metabolism and Disposition: the... May 1995To assess the role of the intestine and the lung in the first-pass uptake of morphine relative to that of the liver, five groups of 6-7 New Zealand rabbits were used. A... (Comparative Study)
Comparative Study
To assess the role of the intestine and the lung in the first-pass uptake of morphine relative to that of the liver, five groups of 6-7 New Zealand rabbits were used. A control group of conscious rabbits received 2 mg/kg of morphine iv. The remaining groups included anesthetized rabbits who received morphine into the aortic cross (2 mg/kg), the jugular vein (2 mg/kg), the portal vein (14 mg/kg), or into the duodenum (20 mg/kg). Multiple blood samples were withdrawn for 3 hr from the abdominal aorta, and morphine and morphine-6-glucuronide were assayed by HPLC. Anesthesia and surgery decreased morphine presystemic clearance from 264 +/- 14 to 194 +/- 12 ml/min/kg (p < 0.05). When morphine was injected into the aortic cross, the area under morphine plasma concentration-time curve (AUCM 0-->infinity) normalized by the dose was 7.81 +/- 0.56 10(-3) kg min/ml, a value that decreased to 5.26 +/- 0.36 (p < 0.05), 2.50 +/- 0.35 (p < 0.05), and 0.87 +/- 0.10 (p < 0.05) 10(-3) kg min/ml when morphine was injected before the lung, liver, or intestine, respectively. The extraction ratio of morphine by the lung, liver, and intestine was 0.33, 0.52, and 0.65, respectively. Compared with the aortic route, the AUCM6G 0-->infinity normalized by the dose ratio tended to be greater (p > 0.05) when morphine was injected into the jugular and portal veins, suggesting that morphine-6-glucuronide is not the major product result of morphine first-pass uptake.(ABSTRACT TRUNCATED AT 250 WORDS)
Topics: Anesthesia; Animals; Consciousness; Injections, Intravenous; Intestinal Mucosa; Liver; Lung; Male; Morphine; Morphine Derivatives; Rabbits
PubMed: 7587935
DOI: No ID Found -
Pharmacology, Biochemistry, and Behavior Nov 2002The main metabolites of morphine, morphine-3-glucuronide (M3G) and morphine-6-glucuronide (M6G), have been considered to participate in some of the effects of morphine.... (Comparative Study)
Comparative Study
The main metabolites of morphine, morphine-3-glucuronide (M3G) and morphine-6-glucuronide (M6G), have been considered to participate in some of the effects of morphine. There is limited knowledge of the pharmacokinetics and dynamics of morphine and the main metabolites in mice, but mice are widely used to study both the analgesic effects and the psychomotor effects of morphine. The present study aimed to explore pharmacokinetic differences between morphine and morphine-glucuronides in mice after different routes of administration, and to investigate how possible differences were reflected in locomotor activity, a measure of psychostimulant properties. Mice were given morphine, M3G or M6G by different routes of administration. Serum concentrations versus time curves, pharmacokinetic parameters and locomotor activity were determined. Intraperitoneal administration of morphine reduced the bioavailability compared to intravenous and subcutaneous administration, but not so for morphine-glucuronides. The two morphine-glucuronides had similar pharmacokinetics, but morphine demonstrated higher volume of distribution and clearance than morphine-glucuronides. The present results demonstrated no locomotor effect of M3G, but a serum concentration effect relationship for morphine and M6G. When serum concentrations and effect changes were followed over time, there was some right hand shifts with respect to locomotor activity, especially during the declining phase of the concentration curve and particularly for M6G.
Topics: Animals; Biological Availability; Male; Mice; Mice, Inbred C57BL; Morphine; Morphine Derivatives; Motor Activity
PubMed: 12213535
DOI: 10.1016/s0091-3057(02)00925-5