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Serum and urine concentrations of morphine and morphine metabolites in patients with advanced cancer receiving continuous intravenous morphine: an observational study

Overview of attention for article published in BMC Palliative Care, October 2015
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Title
Serum and urine concentrations of morphine and morphine metabolites in patients with advanced cancer receiving continuous intravenous morphine: an observational study
Published in
BMC Palliative Care, October 2015
DOI 10.1186/s12904-015-0052-9
Pubmed ID
Authors

Yong Joo Lee, Sang-Yeon Suh, Junghan Song, Sanghee Shiny Lee, Ah-Ram Seo, Hong-Yup Ahn, Myung Ah Lee, Chul-Min Kim, Pål Klepstad

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.

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Mendeley readers

The data shown below were compiled from readership statistics for 28 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Czechia 1 4%
Unknown 27 96%

Demographic breakdown

Readers by professional status Count As %
Other 4 14%
Student > Bachelor 4 14%
Student > Doctoral Student 3 11%
Student > Master 3 11%
Student > Ph. D. Student 3 11%
Other 6 21%
Unknown 5 18%
Readers by discipline Count As %
Medicine and Dentistry 9 32%
Pharmacology, Toxicology and Pharmaceutical Science 4 14%
Chemistry 2 7%
Agricultural and Biological Sciences 1 4%
Computer Science 1 4%
Other 6 21%
Unknown 5 18%