Pharmacology of Morphine in Obese Patients: Clinical Implications

Overview

Journal Clin Pharmacokinet

Specialty Pharmacology

Date 2009 Sep 12

PMID 19743886

Citations 20

Authors

Celia Lloret Linares

Xavier Decleves

Jean Michel Oppert

Arnaud Basdevant

Karine Clement

Christophe Bardin

Jean Michel Scherrmann

Jean Pierre Lepine

Jean Francois Bergmann

Stephane Mouly

Affiliations

Soon will be listed here.

Abstract

Morphine is an analgesic drug used to treat acute and chronic pain. Obesity is frequently associated with pain of various origins (e.g. arthritis, fibromyalgia, cancer), which increases the need for analgesic drugs. Obesity changes drug pharmacokinetics, and for certain drugs, specific modalities of prescription have been proposed for obese patients. However, scant data are available regarding the pharmacokinetics and pharmacodynamics of morphine in obesity. Prescription of morphine depends on pain relief but the occurrence of respiratory adverse effects correlates with obesity, and is not currently taken into account. Variations in the volume of distribution, elimination half-life and oral clearance of morphine, as well as recent advances in the respective roles of drug-metabolizing enzymes, catechol-O-methyltransferase and the mu opioid receptor in morphine pharmacokinetics and pharmacodynamics, may contribute to differences between obese and non-obese patients. In addition, drug-drug interactions may alter the disposition of morphine and its glucuronide metabolites, which may either increase the risk of adverse effects or reduce drug efficacy.

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