Collins S L, Faura C C, Moore R A, McQuay H J
Pain Research & Nuffield Department of Anaesthetics, University of Oxford, Oxford Radcliffe Hospital, UK.
J Pain Symptom Manage. 1998 Dec;16(6):388-402. doi: 10.1016/s0885-3924(98)00094-3.
We performed a systematic review of 69 studies with information on 2146 subjects (454 patients and 1692 healthy volunteers) to examine the maximum plasma concentration (Cmax) and the time taken to reach maximum concentration (Tmax) for different oral morphine formulations, and to clarify factors contributing to variability. Data from healthy volunteers reflected that seen for patients but was less variable. There was minimal difference between single and multiple doses, suggesting no accumulation of morphine. For immediate-release morphine there was no difference in either dose-corrected Cmax or Tmax between solution and tablets, or between different salts. For controlled-release formulations, little difference was observed between brands. Only for once-daily formulations was there any difference in absorption between fed and fasted, with a Tmax for fed subjects considerably longer than for fasted. There was no evidence for any difference between values obtained by radioimmunoassay (RIA) or high-performance liquid chromatography (HPLC).
我们对69项研究进行了系统评价，这些研究涉及2146名受试者（454例患者和1692名健康志愿者）的信息，以考察不同口服吗啡制剂的最大血药浓度（Cmax）和达到最大浓度所需时间（Tmax），并阐明导致变异性的因素。来自健康志愿者的数据反映出患者的数据情况，但变异性较小。单次给药和多次给药之间差异极小，表明吗啡无蓄积。对于速释吗啡，溶液剂和片剂之间或不同盐类之间，剂量校正后的Cmax或Tmax均无差异。对于控释制剂，各品牌之间差异不大。仅一日一次的制剂在进食和空腹状态下的吸收存在差异，进食受试者的Tmax明显长于空腹受试者。没有证据表明放射免疫分析（RIA）或高效液相色谱法（HPLC）所测得的值之间存在任何差异。
