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Morphine, morphine-6-glucuronide and morphine-3-glucuronide concentrations in plasma and cerebrospinal fluid during
D Bigler1, Broen C Christensen, J Eriksen
1Pain Clinic, Bispebjerg Hospital, CopenhagenDenmark Department of Pharmacology, University of Copenhagen, CopenhagenDenmark.
Abstract:
The kinetics of morphine, morphine-6-glucuronide (M6G), and morphine-3-glucuronide (M3G) were studied in a 56-year-old female with lung cancer. Long-term treatment with morphine intrathecally 28 mg every 6 h was used for pain control. Cerebrospinal fluid (CSF) concentrations of morphine were high with an elimination half-life of 2.1 h. The plasma/CSF ratios for M6G and M3G were 1:0.8 and 4:1, respectively, suggesting that M6G penetrates the blood-brain barrier more easily than M3G. The low CSF concentrations indicate that M6G played hardly any major analgetic role in the patient studied.