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Morphine sulphation in children.

I Choonara1, Y Ekbom, B Lindström

  • 1Division of Clinical Pharmacology, Akademiska Hospital, Uppsala, Sweden.

British Journal of Clinical Pharmacology
|December 1, 1990
PubMed
Summary
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Neonates and children metabolize morphine differently. Morphine sulphation, a minor metabolic pathway, significantly decreases after the neonatal period, with higher morphine-3-sulphate (M3S) levels observed in neonates compared to children.

Area of Science:

  • Pharmacology
  • Pediatric Medicine
  • Drug Metabolism

Background:

  • Morphine is a widely used analgesic in pediatric populations.
  • Understanding morphine metabolism in neonates and children is crucial for safe and effective pain management.
  • Limited data exists on the specific metabolic pathways of morphine in these vulnerable age groups.

Purpose of the Study:

  • To investigate and compare the metabolism of morphine in preterm neonates and children.
  • To quantify the formation of morphine metabolites, specifically morphine-3-sulphate (M3S) and morphine-6-sulphate (M6S).
  • To determine if age-related differences exist in morphine sulphation.

Main Methods:

  • Continuous infusion of morphine was administered to nine children and seven preterm neonates.

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  • Urine and plasma samples were collected and analyzed for morphine and its sulphated metabolites (M3S and M6S).
  • Statistical analysis was performed to compare metabolite concentrations and ratios between the two age groups.

    • Main Results:

    • Morphine-3-sulphate (M3S) was detected in the urine of all neonates and three children.
    • Morphine-6-sulphate (M6S) was not detected in the urine or plasma of any participants.
    • M3S concentrations in plasma were undetectable in children.
    • The ratio of M3S to morphine was significantly higher in neonates than in children (P < 0.01).

    Conclusions:

    • Morphine sulphation is a minor metabolic pathway for morphine in both neonates and children.
    • Morphine sulphation significantly decreases after the neonatal period.
    • The findings suggest potential differences in morphine pharmacokinetics and pharmacodynamics between neonates and older children.