Lugo Ralph A, Kern Steven E
College of Pharmacy, and School of Medicine, University of Utah, Salt Lake City, UT 84112-5820, USA.
J Pain Palliat Care Pharmacother. 2002;16(4):5-18. doi: 10.1080/j354v16n04_02.
Morphine, the most widely used mu-opioid analgesic for acute and chronic pain, is the standard against which new analgesics are measured. A thorough understanding of the pharmacokinetics of morphine is required in order to safely and effectively use this analgesic in a wide variety of patients with different levels of organ function. A MEDLINE search was conducted to identify literature published between 1966 and January 2002 relevant to the pharmacokinetics of morphine. These publications were reviewed and the literature summarized regarding unique and clinically important elements of morphine disposition relative to its parenteral administration (including intravenous, intramuscular, subcutaneous, epidural and intrathecal administration), absorption profile (immediate release, controlled release, and sublingual/buccal, and rectal administration), distribution, and its metabolism/excretion. Special populations, including infants, elderly, and those with renal/liver failure, have a unique morphine pharmacokinetic profile that must be taken into account in order to maximize analgesic efficacy and reduce the risk of adverse events.
吗啡是用于急慢性疼痛最广泛使用的μ阿片类镇痛药，是衡量新型镇痛药的标准。为了在各种器官功能水平不同的患者中安全有效地使用这种镇痛药，需要全面了解吗啡的药代动力学。进行了MEDLINE检索，以识别1966年至2002年1月间发表的与吗啡药代动力学相关的文献。对这些出版物进行了综述，并总结了有关吗啡经胃肠外给药（包括静脉内、肌内、皮下、硬膜外和鞘内给药）、吸收情况（速释、控释、舌下/颊部和直肠给药）、分布及其代谢/排泄的独特且具有临床重要意义的要素的文献。特殊人群，包括婴儿、老年人以及肾衰竭/肝功能衰竭患者，具有独特的吗啡药代动力学特征，为了使镇痛效果最大化并降低不良事件风险，必须予以考虑。
