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Published on: July 29, 2014
Morphine Use in Renal Failure: A Case Report of Single-Dose Morphine Toxicity in a Patient Requiring Peritoneal
Nicole A Slater1, Anthony M Todd2, Marirose C Trimmier2
1Department of Pharmacy Practice, Harrison School of Pharmacy, 1383Auburn University, AL, USA.
Objective:
We describe a case of morphine toxicity presumably caused by accumulation of its active metabolite morphine-6-glucuronide (M6G) secondary to reduced clearance by peritoneal dialysis.
Methods:
We present the relevant history and laboratory data and review pertinent literature regarding the use of opioids in renal failure.
Results:
A 76-year-old African-American female received one dose of morphine sulfate and developed signs and symptoms of morphine toxicity for 2 days, even after multiple peritoneal dialysis sessions.
Conclusion:
Because of reduced renal clearance of morphine and its metabolites in patients requiring peritoneal dialysis, morphine should be avoided as an analgesic option in this population due to increased risk of morphine toxicity.
Insights
Morphine toxicity occurred in a patient due to its metabolite, morphine-6-glucuronide, accumulating during peritoneal dialysis. This highlights the risk of using morphine in patients with renal impairment undergoing dialysis.
Area of Science:
- Pharmacology
- Nephrology
- Toxicology
Background:
- Opioid analgesics are commonly used for pain management.
- Renal impairment can affect drug metabolism and excretion.
- Peritoneal dialysis may not effectively clear certain drug metabolites.
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