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Titolo:
CODEINE IN POSTOPERATIVE PAIN - STUDY OF THE INFLUENCE OF SPARTEINE PHENOTYPE AND SERUM CONCENTRATIONS OF MORPHINE AND MORPHINE-6-GLUCURONIDE
Autore:
POULSEN L; RIISHEDE L; BROSEN K; CLEMENSEN S; SINDRUP SH;
Indirizzi:
ODENSE UNIV,DEPT CLIN PHARMACOL,WINSLOWPARKEN 19 DK-5000 ODENSE C DENMARK ODENSE UNIV,DEPT CLIN PHARMACOL DK-5000 ODENSE C DENMARK FAABORG SYGEHUS,DEPT ANAESTHESIOL FABORG DENMARK
Titolo Testata:
European Journal of Clinical Pharmacology
fascicolo: 6, volume: 54, anno: 1998,
pagine: 451 - 454
SICI:
0031-6970(1998)54:6<451:CIPP-S>2.0.ZU;2-Q
Fonte:
ISI
Lingua:
ENG
Soggetto:
OXIDATION POLYMORPHISM; DEBRISOQUINE OXIDATION; PLASMA-CONCENTRATIONS; POOR METABOLIZERS; PHARMACOKINETICS; HYDROXYLATION; ANALGESIA; SINGLE;
Keywords:
POSTOPERATIVE PAIN; CODEINE;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
19
Recensione:
Indirizzi per estratti:
Citazione:
L. Poulsen et al., "CODEINE IN POSTOPERATIVE PAIN - STUDY OF THE INFLUENCE OF SPARTEINE PHENOTYPE AND SERUM CONCENTRATIONS OF MORPHINE AND MORPHINE-6-GLUCURONIDE", European Journal of Clinical Pharmacology, 54(6), 1998, pp. 451-454

Abstract

Objective: Within the past decade, human experimental pain studies have supported the 50-year-old hypothesis that codeine is a prodrug, which has to be converted to morphine to exert an analgesic effect. This study aimed at evaluating the impact of sparteine phenotype and serum concentrations of morphine on the efficacy of codeine in post-operative pain. Methods: Eighty-one patients with a pain rating of 3 or more on a 0-10 numerical rating scale 0.5 h after surgery were included in the study. The patients were given an oral dose of 100 mg codeine and rated pain with the numerical rating scale 0.5 h and 1 h after medication. Blood for determination of serum concentration of codeine and its metabolites was collected 1 h after medication, and a 12-h urine sample after administration of 100 mg sparteine was used to determine the sparteine phenotype. Results: Eight patients were poor metabolizers and66 were extensive metabolizers of sparteine, while the urine samples for the remaining seven patients were lost. In 22 patients, including the eight poor metabolizers, the serum concentrations of both morphineand morphine-6-glucuronide (M6G) were below the limit of determination of the assay, i.e. 1.5 nmol . l(-1) and 2 nmol . l(-1), respectively. A sum of the concentration of these two substances below 10 nmol . l(-1) was found in an additional eight patients. The sum of differencesbetween pre- and post-operative pain ratings did not differ between the two phenotypes (P = 0.60), whereas the 30 patients with serum concentrations of morphine plus M6G below 10 nmol . l(-1) had a marginally significant lower sum than the 51 patients with higher levels of thesesubstances (median 1.5 vs 2.5, P = 0.058). Conclusion: A low serum concentration of morphine and M6G seems to be common in patients treatedwith codeine for post-operative pain, and low concentrations of theseactive substances may be related to decreased efficacy of codeine.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 20/01/20 alle ore 08:11:48