Nagasawa Kazuki, Kintsuji Sumiko, Nakanishi Hirokazu, Nagai Katsuhito, Fujimoto Sadaki
Department of Environmental Biochemistry, Kyoto Pharmaceutical University, 5 Nakauchi-cho, Misasagi, Yamashina-ku, Kyoto 607-8414, Japan.
Int J Pharm. 2003 Oct 20;265(1-2):65-73. doi: 10.1016/s0378-5173(03)00406-x.
This study was performed to assess the pharmacokinetics of morphine and its major metabolites after its rectal or colostomal administration in rectal-resected (ROP) or colostoma-constructed (SOP) rabbits, respectively. The pharmacokinetics of morphine, morphine-3-glucuronide (M3G), and M6G in normal rabbits appeared to be similar to those in human, judging from their plasma concentration-time profiles and the susceptibility of morphine to first-pass metabolism. In SOP, but not ROP, rabbits, the plasma concentrations of morphine, M3G and M6G were significantly increased compared with those in normal rabbits. The AUC of morphine and its metabolites, and the F value of the former in the SOP group were greater than those in the control group, while the elimination half-life (t(1/2)) values were comparable in the two groups. In addition, the disposition of morphine and its metabolites after intravenous (i.v.) administration to SOP rabbits was almost the same as that in normal rabbits, suggesting that an increase in the rate of absorption of morphine in SOP rabbits was not due to inflammation at the absorption site caused by operation, but probably due to its increased solubility in loose stools. Therefore, great attention should be paid when morphine suppositories are intracolostomally administered to colostoma-constructed patients.
本研究旨在分别评估吗啡在直肠切除(ROP)或造口术构建(SOP)兔中经直肠或结肠造口给药后及其主要代谢产物的药代动力学。从吗啡的血浆浓度-时间曲线以及吗啡对首过代谢的敏感性判断,正常兔中吗啡、吗啡-3-葡萄糖醛酸苷(M3G)和M6G的药代动力学似乎与人类相似。在SOP兔而非ROP兔中,吗啡、M3G和M6G的血浆浓度与正常兔相比显著升高。SOP组中吗啡及其代谢产物的AUC以及前者的F值均大于对照组,而两组的消除半衰期(t(1/2))值相当。此外,SOP兔静脉注射(i.v.)吗啡及其代谢产物后的处置情况与正常兔几乎相同,这表明SOP兔中吗啡吸收速率的增加并非由于手术引起的吸收部位炎症,而可能是由于其在稀便中的溶解度增加。因此,当给造口术构建患者经结肠造口给予吗啡栓剂时应格外注意。