A Compartmental Analysis for Morphine and Its Metabolites in Young Children After a Single Oral Dose

Clinical Pharmacokinetics
Nieves Velez de MendizabalBruce C Carleton

Abstract

Currently, the majority of the surgical procedures performed in paediatric hospitals are done on a day care basis, with post-operative pain being managed by caregivers at home. Pain after discharge of these post-operative children has historically been managed with oral codeine in combination with paracetamol (acetaminophen). Codeine is an opioid, which elicits its analgesic effects via metabolism to morphine and codeine-6-glucuronide. Oral morphine is a feasible alternative for outpatient analgesia; however, the pharmacokinetics of morphine after oral administration have been previously described only sparsely, and there is little information in healthy children. The clinical trial included 40 children from 2 to 6 years of age, with an American Society of Anaesthesiologists physical status classification of 1 or 2, who were undergoing surgical procedures requiring opioid analgesia. Morphine was orally administered prior to surgery in one of three doses: 0.1 mg/kg, 0.2 mg/kg and 0.3 mg/kg. Blood samples were collected for plasma morphine, morphine-3-glucuronide (M3G) and morphine-6-glucuronide (M6G) concentrations at 30, 60, 90, 120, 180 and 240 min after administration. All analyses were performed with the non-linear mixed-eff...Continue Reading

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Citations

Oct 26, 2016·Paediatric Anaesthesia·Joy M DawesCarolyne J Montgomery
Mar 7, 2019·Journal of Clinical Pharmacology·Tao LiuJogarao Gobburu
Apr 23, 2019·European Journal of Drug Metabolism and Pharmacokinetics·James C ThigpenSam Harirforoosh
Jan 25, 2018·Expert Opinion on Drug Metabolism & Toxicology·Tamara Van DongeKarel Allegaert
Mar 23, 2021·Paediatrics & Child Health·Michael J Rieder, Geert 't Jong
Mar 23, 2021·Paediatrics & Child Health·Michael J Rieder, Geert 't Jong

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