Evidence of morphine metabolism to hydromorphone in pain patients chronically treated with morphine

Journal of Analytical Toxicology
Edward J ConeDouglas Gourlay

Abstract

Minor metabolic pathways in human subjects have been shown to exist for the conversion of codeine to hydrocodone but have not been reported for the metabolic conversion of morphine to hydromorphone. In this study, urine specimens were collected in an out-patient setting from 13 pain patients who were chronically treated with morphine and other opioids (methadone, oxycodone, and fentanyl). The chronic pain patients were chosen for study because they were treated with high-dose morphine and had no personal or family history of addiction. Results of the initial evaluation and follow up of these patients with random urine tests did not indicate opioid misuse. The specimens were analyzed by GC-MS for the presence of hydromorphone. The reporting limit for hydromorphone was 100 ng/mL. Ten of the 13 morphine-treated patients excreted hydromorphone in minor amounts ranging 120 to 1400 ng/mL. Concurrent morphine concentrations were exceedingly high in these 10 patients and frequently exceeded the upper limit of linearity (> 10,000 ng/mL) of the assay. The ratio of hydromorphone to morphine ranged from 0.015 to 0.024. Morphine concentrations in the three patients in which hydromorphone was not detected tended to be lower than those observ...Continue Reading

Citations

Aug 1, 2006·Photomedicine and Laser Surgery
Apr 19, 2012·Journal of Analytical Toxicology·Michelle M HughesAmadeo J Pesce
May 27, 2014·Forensic Science International : Synergy·Julie KnightEdward J Cone
Aug 1, 2009·Bioanalysis·Gary M ReisfieldRoger L Bertholf
Jul 12, 2008·Pain Medicine : the Official Journal of the American Academy of Pain Medicine·Ajay D WasanRobert N Jamison
Dec 9, 2008·Clinics in Laboratory Medicine·Kristen K ReynoldsSaeed A Jortani
Dec 7, 2007·Anesthesiology Clinics·Gary McCleane, Howard S Smith
Oct 24, 2007·Peptides·Richard J Bodnar
Feb 27, 2007·The Medical Clinics of North America·Gary McCleane, Howard S Smith
Apr 24, 2010·Pain Practice : the Official Journal of World Institute of Pain·Joseph PergolizziUNKNOWN Integrated Drug Compliance Study Group (IDCSG)
May 6, 2011·CA: a Cancer Journal for Clinicians·Judith A Paice, Betty Ferrell
Apr 14, 2016·Bioanalysis·Milena M MadryMarkus R Baumgartner
Oct 24, 2013·Journal of Pain & Palliative Care Pharmacotherapy·Gwendolyn A McMillinKamisha L Johnson-Davis
Jul 2, 2009·Mayo Clinic Proceedings·Howard S Smith
Apr 4, 2015·Journal of Analytical Toxicology·Jennifer M ColbyKara L Lynch
Jan 8, 2015·Therapeutic Drug Monitoring·Gwendolyn A McMillinMatthew D Krasowski
Mar 7, 2019·Journal of Clinical Pharmacology·Tao LiuJogarao Gobburu
Mar 3, 2007·Annals of the New York Academy of Sciences·Edward J Cone, Marilyn A Huestis
Jul 31, 2009·Postgraduate Medicine·Edward J Cone, Yale H Caplan
Apr 28, 2010·Expert Review of Neurotherapeutics·Laxmaiah ManchikantiHoward Smith
Jul 30, 2019·Traffic Injury Prevention·Eduardo RomanoPedro A Torres-Saavedra
Jul 7, 2017·Drug Testing and Analysis·Alexandra MaasCornelius Hess
Sep 30, 2009·Clinical Chemistry·Gary M ReisfieldRoger L Bertholf
Sep 30, 2009·Clinical Chemistry·Douglas Gourlay, Howard A Heit
Aug 15, 2009·Food Additives & Contaminants. Part A, Chemistry, Analysis, Control, Exposure & Risk Assessment·F RamosM I N Silveira
May 13, 2008·Journal of Forensic Sciences·Pamela C McDonoughDavid Fowler
Oct 13, 2020·Journal of Analytical Toxicology·Sandra C Bishop-FreemanJason S Hudson
Dec 11, 2020·Pain Management·Nicholas J ConnorsHong K Kim
Jan 1, 2018·The Journal of Applied Laboratory Medicine·Philip M SoboleskyRobert L Fitzgerald

❮ Previous
Next ❯

Related Concepts

Related Feeds

Addiction

This feed focuses mechanisms underlying addiction and addictive behaviour including heroin and opium dependence, alcohol intoxication, gambling, and tobacco addiction.