Serum and urine concentrations of morphine and morphine metabolites in patients with advanced cancer receiving continuous intravenous morphine: an observational study
The feasibility and clinical implication of drug monitoring of morphine, morphine-6-glucuronide (M6G) and morphine-3-glucuronide (M3G) need further investigation. This study aimed to determine what predicts serum concentrations of morphine in cancer patients receiving continuously intravenous morphi...
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| Veröffentlicht in: | BMC palliative care 2015-10, Vol.14 (1), p.53-53, Article 53 |
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| creator | Lee, Yong Joo Suh, Sang-Yeon Song, Junghan Lee, Sanghee Shiny Seo, Ah-Ram Ahn, Hong-Yup Lee, Myung Ah Kim, Chul-Min Klepstad, Pål |
| description | The feasibility and clinical implication of drug monitoring of morphine, morphine-6-glucuronide (M6G) and morphine-3-glucuronide (M3G) need further investigation. This study aimed to determine what predicts serum concentrations of morphine in cancer patients receiving continuously intravenous morphine, the relationships between serum concentration of morphine/its metabolites and urinary concentrations, and the relation between morphine concentrations and with clinical outcomes.
We collected serum and urine samples from 24 patients with advanced cancer undergoing continuously intravenous morphine therapy. Serum samples were obtained at day one. Spot urine samples were collected once daily on three consecutive days. Pain and adverse drug events were assessed using the Korean version of MD Anderson Symptom Inventory.
A total of 96 samples (72 urine and 24 serum samples) were collected. Median dose of morphine was 82.0 mg/24 h. In a multivariate analysis, total daily morphine dose was the most significant predictors of both serum and urine concentration of morphine. Morphine, M6G, and M3G in serum and urine were statistical significantly correlated (correlation coefficient = 0.81, 0.44, 0.56; p values |
| doi_str_mv | 10.1186/s12904-015-0052-9 |
| format | Article |
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We collected serum and urine samples from 24 patients with advanced cancer undergoing continuously intravenous morphine therapy. Serum samples were obtained at day one. Spot urine samples were collected once daily on three consecutive days. Pain and adverse drug events were assessed using the Korean version of MD Anderson Symptom Inventory.
A total of 96 samples (72 urine and 24 serum samples) were collected. Median dose of morphine was 82.0 mg/24 h. In a multivariate analysis, total daily morphine dose was the most significant predictors of both serum and urine concentration of morphine. Morphine, M6G, and M3G in serum and urine were statistical significantly correlated (correlation coefficient = 0.81, 0.44, 0.56; p values < 0.01, 0.03, 0.01, respectively).
Spot urine concentrations of morphine and its metabolites were highly correlated to those of serum. Total dose of daily morphine was related to both serum and urine concentration of morphine and its metabolites.</description><identifier>ISSN: 1472-684X</identifier><identifier>EISSN: 1472-684X</identifier><identifier>DOI: 10.1186/s12904-015-0052-9</identifier><identifier>PMID: 26507979</identifier><language>eng</language><publisher>England: BioMed Central Ltd</publisher><subject>Administration, Intravenous ; Adult ; Aged ; Aged, 80 and over ; Analysis ; Cancer patients ; Care and treatment ; Dose-Response Relationship, Drug ; Drug Monitoring - methods ; Female ; Hospice care ; Humans ; Male ; Metabolites ; Middle Aged ; Morphine ; Morphine - blood ; Morphine - metabolism ; Morphine - pharmacology ; Morphine - urine ; Morphine Derivatives - metabolism ; Neoplasms - drug therapy ; Palliative care ; Physiological aspects ; Republic of Korea</subject><ispartof>BMC palliative care, 2015-10, Vol.14 (1), p.53-53, Article 53</ispartof><rights>COPYRIGHT 2015 BioMed Central Ltd.</rights><rights>Copyright BioMed Central 2015</rights><rights>Lee et al. 2015</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c424t-ec6f233309c01731ec2e3bc8e102b03b32ddc1d3f472040665caa891710863a43</citedby><cites>FETCH-LOGICAL-c424t-ec6f233309c01731ec2e3bc8e102b03b32ddc1d3f472040665caa891710863a43</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4624671/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4624671/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26507979$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lee, Yong Joo</creatorcontrib><creatorcontrib>Suh, Sang-Yeon</creatorcontrib><creatorcontrib>Song, Junghan</creatorcontrib><creatorcontrib>Lee, Sanghee Shiny</creatorcontrib><creatorcontrib>Seo, Ah-Ram</creatorcontrib><creatorcontrib>Ahn, Hong-Yup</creatorcontrib><creatorcontrib>Lee, Myung Ah</creatorcontrib><creatorcontrib>Kim, Chul-Min</creatorcontrib><creatorcontrib>Klepstad, Pål</creatorcontrib><title>Serum and urine concentrations of morphine and morphine metabolites in patients with advanced cancer receiving continuous intravenous morphine: an observational study</title><title>BMC palliative care</title><addtitle>BMC Palliat Care</addtitle><description>The feasibility and clinical implication of drug monitoring of morphine, morphine-6-glucuronide (M6G) and morphine-3-glucuronide (M3G) need further investigation. This study aimed to determine what predicts serum concentrations of morphine in cancer patients receiving continuously intravenous morphine, the relationships between serum concentration of morphine/its metabolites and urinary concentrations, and the relation between morphine concentrations and with clinical outcomes.
We collected serum and urine samples from 24 patients with advanced cancer undergoing continuously intravenous morphine therapy. Serum samples were obtained at day one. Spot urine samples were collected once daily on three consecutive days. Pain and adverse drug events were assessed using the Korean version of MD Anderson Symptom Inventory.
A total of 96 samples (72 urine and 24 serum samples) were collected. Median dose of morphine was 82.0 mg/24 h. In a multivariate analysis, total daily morphine dose was the most significant predictors of both serum and urine concentration of morphine. Morphine, M6G, and M3G in serum and urine were statistical significantly correlated (correlation coefficient = 0.81, 0.44, 0.56; p values < 0.01, 0.03, 0.01, respectively).
Spot urine concentrations of morphine and its metabolites were highly correlated to those of serum. Total dose of daily morphine was related to both serum and urine concentration of morphine and its metabolites.</description><subject>Administration, Intravenous</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Analysis</subject><subject>Cancer patients</subject><subject>Care and treatment</subject><subject>Dose-Response Relationship, Drug</subject><subject>Drug Monitoring - methods</subject><subject>Female</subject><subject>Hospice care</subject><subject>Humans</subject><subject>Male</subject><subject>Metabolites</subject><subject>Middle Aged</subject><subject>Morphine</subject><subject>Morphine - blood</subject><subject>Morphine - metabolism</subject><subject>Morphine - pharmacology</subject><subject>Morphine - urine</subject><subject>Morphine Derivatives - metabolism</subject><subject>Neoplasms - drug therapy</subject><subject>Palliative care</subject><subject>Physiological aspects</subject><subject>Republic of Korea</subject><issn>1472-684X</issn><issn>1472-684X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><recordid>eNptUk1v1DAQjRCIlsIP4IIsceGS4q84CQekqqKAVIkDIHGzHGey6yqxFzsJ6h_id3bMtkuLkA8ee9574xm_onjJ6CljjXqbGG-pLCmrSkorXraPimMma16qRv54fC8-Kp6ldEUpqxtZPS2OuKpo3dbtcfH7K8RlIsb3ZInOA7HBW_BzNLMLPpEwkCnE3TanMuhwmGA2XRjdDIk4T3aIR1oiv9y8JaZfDcr0xOYtkggW3Or8JsvPzi9hySyssoLP8Z3sOyxCQpcgrn8eYEaS5qW_fl48GcyY4MXtflJ8v_jw7fxTefnl4-fzs8vSSi7nEqwauBCCthZ7FQwsB9HZBhjlHRWd4H1vWS8GHAyVVKnKGtO0rGa0UcJIcVK83-vulm6Cfj-JUe-im0y81sE4_TDj3VZvwqql4lLVDAXe3ArE8HOBNOvJJQvjaDxgo5rVvOEV1lMIff0P9CosEVvOKPwdRmtZ_UVtzAja-SFgXZtF9VklmRSSq_zu0_-gcPUwOZw5DA7vHxDYnmBjSCnCcOiRUZ3Npffm0mgunc2lW-S8uj-cA-POTeIGOpLOLw</recordid><startdate>20151027</startdate><enddate>20151027</enddate><creator>Lee, Yong Joo</creator><creator>Suh, Sang-Yeon</creator><creator>Song, Junghan</creator><creator>Lee, Sanghee Shiny</creator><creator>Seo, Ah-Ram</creator><creator>Ahn, Hong-Yup</creator><creator>Lee, Myung Ah</creator><creator>Kim, Chul-Min</creator><creator>Klepstad, Pål</creator><general>BioMed Central Ltd</general><general>BioMed Central</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20151027</creationdate><title>Serum and urine concentrations of morphine and morphine metabolites in patients with advanced cancer receiving continuous intravenous morphine: an observational study</title><author>Lee, Yong Joo ; Suh, Sang-Yeon ; Song, Junghan ; Lee, Sanghee Shiny ; Seo, Ah-Ram ; Ahn, Hong-Yup ; Lee, Myung Ah ; Kim, Chul-Min ; Klepstad, Pål</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c424t-ec6f233309c01731ec2e3bc8e102b03b32ddc1d3f472040665caa891710863a43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Administration, Intravenous</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Analysis</topic><topic>Cancer patients</topic><topic>Care and treatment</topic><topic>Dose-Response Relationship, Drug</topic><topic>Drug Monitoring - methods</topic><topic>Female</topic><topic>Hospice care</topic><topic>Humans</topic><topic>Male</topic><topic>Metabolites</topic><topic>Middle Aged</topic><topic>Morphine</topic><topic>Morphine - blood</topic><topic>Morphine - metabolism</topic><topic>Morphine - pharmacology</topic><topic>Morphine - urine</topic><topic>Morphine Derivatives - metabolism</topic><topic>Neoplasms - drug therapy</topic><topic>Palliative care</topic><topic>Physiological aspects</topic><topic>Republic of Korea</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lee, Yong Joo</creatorcontrib><creatorcontrib>Suh, Sang-Yeon</creatorcontrib><creatorcontrib>Song, Junghan</creatorcontrib><creatorcontrib>Lee, Sanghee Shiny</creatorcontrib><creatorcontrib>Seo, Ah-Ram</creatorcontrib><creatorcontrib>Ahn, Hong-Yup</creatorcontrib><creatorcontrib>Lee, Myung Ah</creatorcontrib><creatorcontrib>Kim, Chul-Min</creatorcontrib><creatorcontrib>Klepstad, Pål</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Access via ProQuest (Open Access)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>BMC palliative care</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lee, Yong Joo</au><au>Suh, Sang-Yeon</au><au>Song, Junghan</au><au>Lee, Sanghee Shiny</au><au>Seo, Ah-Ram</au><au>Ahn, Hong-Yup</au><au>Lee, Myung Ah</au><au>Kim, Chul-Min</au><au>Klepstad, Pål</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Serum and urine concentrations of morphine and morphine metabolites in patients with advanced cancer receiving continuous intravenous morphine: an observational study</atitle><jtitle>BMC palliative care</jtitle><addtitle>BMC Palliat Care</addtitle><date>2015-10-27</date><risdate>2015</risdate><volume>14</volume><issue>1</issue><spage>53</spage><epage>53</epage><pages>53-53</pages><artnum>53</artnum><issn>1472-684X</issn><eissn>1472-684X</eissn><abstract>The feasibility and clinical implication of drug monitoring of morphine, morphine-6-glucuronide (M6G) and morphine-3-glucuronide (M3G) need further investigation. This study aimed to determine what predicts serum concentrations of morphine in cancer patients receiving continuously intravenous morphine, the relationships between serum concentration of morphine/its metabolites and urinary concentrations, and the relation between morphine concentrations and with clinical outcomes.
We collected serum and urine samples from 24 patients with advanced cancer undergoing continuously intravenous morphine therapy. Serum samples were obtained at day one. Spot urine samples were collected once daily on three consecutive days. Pain and adverse drug events were assessed using the Korean version of MD Anderson Symptom Inventory.
A total of 96 samples (72 urine and 24 serum samples) were collected. Median dose of morphine was 82.0 mg/24 h. In a multivariate analysis, total daily morphine dose was the most significant predictors of both serum and urine concentration of morphine. Morphine, M6G, and M3G in serum and urine were statistical significantly correlated (correlation coefficient = 0.81, 0.44, 0.56; p values < 0.01, 0.03, 0.01, respectively).
Spot urine concentrations of morphine and its metabolites were highly correlated to those of serum. Total dose of daily morphine was related to both serum and urine concentration of morphine and its metabolites.</abstract><cop>England</cop><pub>BioMed Central Ltd</pub><pmid>26507979</pmid><doi>10.1186/s12904-015-0052-9</doi><tpages>1</tpages><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; DOAJ Directory of Open Access Journals; SpringerNature Journals; PubMed Central Open Access; Springer Nature OA Free Journals; EZB-FREE-00999 freely available EZB journals; PubMed Central |
| subjects | Administration, Intravenous Adult Aged Aged, 80 and over Analysis Cancer patients Care and treatment Dose-Response Relationship, Drug Drug Monitoring - methods Female Hospice care Humans Male Metabolites Middle Aged Morphine Morphine - blood Morphine - metabolism Morphine - pharmacology Morphine - urine Morphine Derivatives - metabolism Neoplasms - drug therapy Palliative care Physiological aspects Republic of Korea |
| title | Serum and urine concentrations of morphine and morphine metabolites in patients with advanced cancer receiving continuous intravenous morphine: an observational study |
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