Li Y, Looney G A, Kimler B F, Hurwitz A
Department of Internal Medicine, University of Kansas Medical Center, Kansas City 66160-7320, USA.
Cancer Chemother Pharmacol. 1997;39(3):273-7. doi: 10.1007/s002800050572.
This study was performed to investigate the effects of morphine on the disposition of 5-fluorouracil (5-FU).
Mice were injected subcutaneously (s.c.) with saline or morphine, 20 mg/kg. 5-FU was administered intravenously (i.v.) 30 min later as a single bolus or by constant infusion. Blood samples were obtained by orbital sinus puncture. Urine samples were obtained from the bladder after ligation of the external urethra. 5-FU concentrations in plasma and urine were determined by HPLC.
Morphine markedly elevated plasma levels of 5-FU given at doses of 100 to 860 mg/kg. The plasma clearance rate of a bolus dose of 100 mg/kg 5-FU was significantly reduced from 54 to 28 ml/min per kg and the elimination half-life was increased from 6.9 to 12.2 min by prior administration of morphine. When 5-FU was infused at 0.5 mg/kg per min, morphine reduced its plasma clearance rate from 145 to 94 ml/min per kg. Mice made tolerant by prior morphine administration required higher doses of this opiate to raise 5-FU levels as well as to cause analgesia. The effects of morphine on 5-FU disposition were antagonized by naltrexone. Excretion of 5-FU in urine was not affected by morphine treatment.
The plasma clearance rate of 5-FU in mice is significantly reduced by concomitant use of morphine. This effect of morphine is due to reduced hepatic elimination of 5-FU rather than to a decrease in its renal excretion.
本研究旨在探讨吗啡对5-氟尿嘧啶(5-FU)处置的影响。
给小鼠皮下注射生理盐水或20mg/kg吗啡。30分钟后静脉注射5-FU,注射方式为单次推注或持续输注。通过眶窦穿刺采集血样。结扎尿道外口后从膀胱采集尿样。采用高效液相色谱法测定血浆和尿液中的5-FU浓度。
吗啡显著提高了给予剂量为100至860mg/kg的5-FU的血浆水平。预先给予吗啡后,100mg/kg 5-FU单次推注剂量的血浆清除率从54ml/min per kg显著降低至28ml/min per kg,消除半衰期从6.9分钟延长至12.2分钟。当以0.5mg/kg per min的速度输注5-FU时,吗啡将其血浆清除率从145ml/min per kg降低至94ml/min per kg。预先给予吗啡使其产生耐受性的小鼠需要更高剂量的这种阿片类药物来提高5-FU水平以及产生镇痛作用。纳曲酮可拮抗吗啡对5-FU处置的影响。吗啡治疗对5-FU的尿排泄无影响。
同时使用吗啡可显著降低小鼠体内5-FU的血浆清除率。吗啡的这种作用是由于肝脏对5-FU的清除减少,而非其肾脏排泄减少所致。