肾衰竭中的二氢可待因：肾脏在阿片类药物处理中起重要作用的进一步证据。
Dihydrocodeine in renal failure: further evidence for an important role of the kidney in the handling of opioid drugs.
作者信息
Barnes J N, Williams A J, Tomson M J, Toseland P A, Goodwin F J
出版信息
Br Med J (Clin Res Ed). 1985 Mar 9;290(6470):740-2. doi: 10.1136/bmj.290.6470.740.
Abstract
The pharmacokinetics of a single oral dose of dihydrocodeine were studied in nine patients with chronic renal failure treated by haemodialysis and nine subjects with normal renal function. In the patients the mean peak plasma dihydrocodeine concentration occurred later and the area under the curve was greater than in the normal subjects. Furthermore, the drug was still detectable after 24 hours in all the patients but only three of the normal subjects. These data, together with those obtained from previously published clinical case reports, contradict the traditional view that the body's ability to cope with opioid drugs is not altered in renal failure.
摘要
在9例接受血液透析治疗的慢性肾衰竭患者和9例肾功能正常的受试者中，研究了单次口服二氢可待因的药代动力学。与正常受试者相比，患者的血浆二氢可待因平均峰值浓度出现较晚，曲线下面积更大。此外，所有患者在24小时后仍可检测到该药物，而正常受试者中只有3例能检测到。这些数据，连同先前发表的临床病例报告中获得的数据，与传统观点相矛盾，即肾衰竭时人体应对阿片类药物的能力不会改变。
相似文献
1
Dihydrocodeine in renal failure: further evidence for an important role of the kidney in the handling of opioid drugs.肾衰竭中的二氢可待因：肾脏在阿片类药物处理中起重要作用的进一步证据。
Br Med J (Clin Res Ed). 1985 Mar 9;290(6470):740-2. doi: 10.1136/bmj.290.6470.740.
2
The effect of ageing on the pharmacokinetics of dihydrocodeine.衰老对二氢可待因药代动力学的影响。
Eur J Clin Pharmacol. 1989;37(4):375-9. doi: 10.1007/BF00558503.
3
Opioid drugs and renal failure.阿片类药物与肾衰竭。
Lancet. 1984 Sep 29;2(8405):748. doi: 10.1016/s0140-6736(84)92651-5.
4
Pharmacokinetics of mycophenolate mofetil in patients with end-stage renal failure.霉酚酸酯在终末期肾衰竭患者中的药代动力学。
Kidney Int. 2000 Mar;57(3):1164-8. doi: 10.1046/j.1523-1755.2000.00943.x.
5
Dihydrocodeine in renal failure.肾衰竭中的双氢可待因。
Br Med J (Clin Res Ed). 1985 Apr 27;290(6477):1287. doi: 10.1136/bmj.290.6477.1287.
6
Metabolism and pharmacokinetics of dihydrocodeine in dog.双氢可待因在犬体内的代谢及药代动力学
Xenobiotica. 1994 Jul;24(7):591-601. doi: 10.3109/00498259409043262.
7
Effect of severe renal failure and haemodialysis on the pharmacokinetics of levosimendan and its metabolites.严重肾衰竭和血液透析对左西孟旦及其代谢产物药代动力学的影响。
Clin Pharmacokinet. 2007;46(3):235-46. doi: 10.2165/00003088-200746030-00004.
8
Postmortem distribution of dihydrocodeine and metabolites in a fatal case of dihydrocodeine intoxication.
Forensic Sci Int. 1998 Jul 20;95(2):99-107. doi: 10.1016/s0379-0738(98)00091-7.
9
Dihydrocodeine: a new opioid substrate for the polymorphic CYP2D6 in humans.双氢可待因：一种用于人类多态性CYP2D6的新型阿片类底物。
Clin Pharmacol Ther. 1995 Oct;58(4):374-82. doi: 10.1016/0009-9236(95)90049-7.
10
Pharmacokinetics of intravenous and oral dihydrocodeine and its acid metabolites.静脉注射和口服二氢可待因及其酸性代谢产物的药代动力学
Eur J Clin Pharmacol. 1983;25(3):419-24. doi: 10.1007/BF01037958.
引用本文的文献
1
Population pharmacokinetics of telapristone (CDB-4124) and its active monodemethylated metabolite CDB-4453, with a mixture model for total clearance.替拉瑞司酮（CDB-4124）及其活性单去甲基代谢物 CDB-4453 的群体药代动力学，采用混合模型估算总清除率。
AAPS J. 2011 Dec;13(4):665-73. doi: 10.1208/s12248-011-9304-7. Epub 2011 Oct 25.
2
An analysis of discharge drug prescribing amongst elderly patients with renal impairment.老年肾功能损害患者出院用药处方分析。
Postgrad Med J. 1998 Jul;74(873):420-2. doi: 10.1136/pgmj.74.873.420.
3
Pain treatment in multimorbid patients, the older population and other high-risk groups. The clinical challenge of reducing toxicity.多病共存患者、老年人群及其他高危群体的疼痛治疗。降低毒性的临床挑战。
Drug Saf. 1998 Jun;18(6):457-72. doi: 10.2165/00002018-199818060-00006.
4
Drug administration in patients with renal insufficiency. Minimising renal and extrarenal toxicity.肾功能不全患者的药物给药。将肾毒性和肾外毒性降至最低。
Drug Saf. 1997 Mar;16(3):205-31. doi: 10.2165/00002018-199716030-00005.
5
Principles of drug administration in renal insufficiency.肾功能不全时的给药原则
Clin Pharmacokinet. 1997 Jan;32(1):30-57. doi: 10.2165/00003088-199732010-00002.
6
Pharmacokinetics of opioids in renal dysfunction.肾功能不全患者中阿片类药物的药代动力学。
Clin Pharmacokinet. 1996 Dec;31(6):410-22. doi: 10.2165/00003088-199631060-00002.
7
The altered pharmacokinetics and pharmacodynamics of drugs commonly used in critically ill patients.危重症患者常用药物的药代动力学和药效学改变。
Clin Pharmacokinet. 1988 Jun;14(6):347-73. doi: 10.2165/00003088-198814060-00003.
8
Morphine intoxication in renal failure; the role of morphine-6-glucuronide.肾衰竭中的吗啡中毒；吗啡-6-葡萄糖醛酸的作用。
Br Med J (Clin Res Ed). 1986 Oct 25;293(6554):1101. doi: 10.1136/bmj.293.6554.1101.
9
Guide to drug dosage in renal failure.肾衰竭药物剂量指南。
Clin Pharmacokinet. 1988 Nov;15(5):326-54. doi: 10.2165/00003088-198815050-00005.
10
The effect of ageing on the pharmacokinetics of dihydrocodeine.衰老对二氢可待因药代动力学的影响。
Eur J Clin Pharmacol. 1989;37(4):375-9. doi: 10.1007/BF00558503.
本文引用的文献
1
The metabolic fate of codeine in man.可待因在人体内的代谢转归
J Pharmacol Exp Ther. 1955 Jul;114(3):251-62.
2
Transport and metabolism of [3H]morphine in isolated, nonperfused proximal tubular segments of the rabbit kidney.
J Pharmacol Exp Ther. 1982 Dec;223(3):811-5.
3
Metabolism of narcotics.麻醉品的代谢
Br Med J (Clin Res Ed). 1984 Jan 21;288(6412):237. doi: 10.1136/bmj.288.6412.237.
4
Dihydrocodeine narcosis in renal failure.肾衰竭中的二氢可待因麻醉
Br Med J (Clin Res Ed). 1983 Feb 5;286(6363):438-9. doi: 10.1136/bmj.286.6363.438-a.
5
Morphine kinetics during and after renal transplantation.肾移植术中及术后的吗啡药代动力学。
Clin Pharmacol Ther. 1984 May;35(5):641-5. doi: 10.1038/clpt.1984.88.
6
Drug prescribing in renal failure: dosing guidelines for adults.
Am J Kidney Dis. 1983 Nov;3(3):155-93. doi: 10.1016/s0272-6386(83)80060-2.
7
Gastric acid secretion in chronic renal failure.慢性肾衰竭中的胃酸分泌
Br Med J. 1972 Oct 7;4(5831):22-3. doi: 10.1136/bmj.4.5831.22.
8
Stop-flow analysis of the renal excretion of tritium-labeled dihydromorphine.氚标记二氢吗啡肾排泄的停流分析
J Pharmacol Exp Ther. 1965 Nov;150(2):259-69.
9
Narcotic analgesics in anuric patients.无尿患者使用麻醉性镇痛药。
Anesthesiology. 1975 Jun;42(6):745-7. doi: 10.1097/00000542-197506000-00021.
10
Morphine and phenytoin binding to plasma proteins in renal and hepatic failure.
Clin Pharmacol Ther. 1975 Jun;17(6):677-84. doi: 10.1002/cpt1975176677.
Zotero 插件