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马肌肉注射吗啡的药代动力学

Pharmacokinetics of intramuscularly administered morphine in horses.

作者信息

Devine Elizabeth P, KuKanich Butch, Beard Warren L

机构信息

Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, KS 66502, USA.

出版信息

J Am Vet Med Assoc. 2013 Jul 1;243(1):105-12. doi: 10.2460/javma.243.1.105.

Abstract

OBJECTIVE

To determine the pharmacokinetics of morphine after IM administration in a clinical population of horses.

DESIGN

Prospective clinical study.

ANIMALS

77 horses.

PROCEDURES

Morphine sulfate (0.1 mg/kg [0.045 mg/lb], IM) was administered to horses, and blood samples were obtained at predetermined time points. Plasma morphine concentrations were measured via liquid chromatography and mass spectrometry. In preliminary investigations, samples were obtained from 2 healthy horses at 12 time points (up to 12 hours after drug administration) and analyzed via 2-stage pharmacokinetic analysis. In the clinical phase, blood samples were obtained from 75 hospitalized horses at various times (total, 2 to 3 samples/horse) up to 9 hours after drug administration, and data were analyzed via a naïve pooled pharmacokinetic model.

RESULTS

In the clinical phase, the apparent terminal half-life (t(½)) of morphine was approximately 1.5 hours, volume of distribution per bioavailability was approximately 4.5 L/kg, and clearance per bioavailability was approximately 35 mL/kg/min. Peak plasma concentration in naïve pooled analysis was 21.6 ng/mL and occurred approximately 4 minutes after administration. Morphine concentrations were below the limit of quantification ≤ 7 hours after administration in 74 horses. Adverse effects attributed to morphine administration were uncommon and considered mild.

CONCLUSIONS AND CLINICAL RELEVANCE

The short t(½) of morphine in horses suggested frequent administration may be needed to maintain targeted plasma concentrations. Variations in plasma concentrations suggested optimal dosages may differ among horses. The drug was well tolerated at the described dose, but patients receiving morphine should be monitored carefully.

摘要

目的

确定吗啡在马临床群体中肌内注射后的药代动力学。

设计

前瞻性临床研究。

动物

77匹马。

步骤

给马注射硫酸吗啡(0.1mg/kg[0.045mg/磅],肌内注射),并在预定时间点采集血样。通过液相色谱和质谱法测量血浆吗啡浓度。在初步研究中,从2匹健康马身上在12个时间点(给药后长达12小时)采集样本,并通过两阶段药代动力学分析进行分析。在临床阶段,从75匹住院马身上在给药后长达9小时的不同时间采集血样(总共,每匹马2至3个样本),并通过简单合并药代动力学模型分析数据。

结果

在临床阶段,吗啡的表观终末半衰期(t(½))约为1.5小时,每生物利用度的分布容积约为4.5L/kg,每生物利用度的清除率约为35mL/kg/分钟。简单合并分析中的血浆峰值浓度为21.6ng/mL,给药后约4分钟出现。74匹马在给药后≤7小时时吗啡浓度低于定量限。归因于吗啡给药的不良反应不常见且被认为轻微。

结论及临床意义

马体内吗啡的短t(½)表明可能需要频繁给药以维持目标血浆浓度。血浆浓度的变化表明不同马匹的最佳剂量可能不同。在所描述的剂量下该药物耐受性良好,但接受吗啡治疗的患者应仔细监测。

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