Analgesia and serum assays of controlled-release dihydrocodeine and metabolites in cancer patients with pain.
Journal Title: Pharmacological Reports - Year 2012, Vol 64, Issue 1
Abstract
Aim of the study was to assess dihydrocodeine (DHC) and metabolites concentrations and their correlations with DHC analgesia in cancer patients with pain. Thirty opioid-naive patients with nociceptive pain intensity assessed by VAS (visual analogue scale) > 40 received controlled-release DHC as the first (15 patients, 7 days) or as the second opioid (15 patients, 7 days). Blood samples were taken on day 2, 4 and 7 at each study period. DHC and its metabolites were assayed by HPLC. DHC provided satisfactory analgesia when administered as the first or the second opioid superior to that of tramadol. When DHC was the first opioid administered, DHC and dihydrocodeine-6-glucuronide (DHC-6-G) concentrations increased in the second and the third comparing to the first assay. A trend of nordihydromorphine (NDHM) level fall between the first and the third assay was noted; trends of dihydromorphine (DHM) level increase in the second relative to the first determination and decrease in the third compared to the second assay were observed. When DHC followed tramadol treatment a trend of DHC concentration increase in the second relative to the first assay was noted. DHC-6-G level increased in the second and in the third comparing to the first determination; NDHM and DHM concentrations were stable. DHC and DHC-6-G concentrations increased similarly during both treatment periods which suggest their prominent role in DHC analgesia. Few significant correlations were found between DHC dose, DHC and metabolites serum concentrations with analgesia suggesting the individual DHC dose titration.
Authors and Affiliations
Wojciech Leppert, Przemysław Mikołajczak, Ewa Kamińska, Michał Szulc
Keywords
Related Articles
- EP ID EP108711
- DOI -
- Views 82
- Downloads 0
Cannabinoid CB1 receptors in rat medial prefrontal cortex are colocalized with calbindin- but not parvalbumin- and calretinin-positive GABA-ergic neurons.
In the present study, we investigate putative localization of cannabinoid receptors 1 (CB1) protein on a population of cortical gamma-aminobutyric acid (GABA) - positive interneurons characterized by expression of calciu...
Modification of morphine analgesia by venlafaxine in diabetic neuropathic pain model.
Background: The purpose of this study was to investigate the influence of single or chronic (21 days) administration of the serotonin and noradrenaline reuptake inhibitor, venlafaxine, on the antinociceptive action of th...
Lack of effect of sildenafil on cocaine-induced convulsions in mice.
The convulsant action of cocaine and the proconvulsant effects of sildenafil, a drug which is widely used in the treatment of erectile dysfunction, have been documented both in humans and mice. Since it was reported that...
Identification of factors mediating the effect of the brain dopaminergic system on the expression of cytochrome P450 in the liver.
Our earlier study showed that damage to brain dopaminergic pathways causes decreases in CYP2B, CYP2C11 and CYP3A, as well as increases in CYP1A protein levels and activities in the liver. The aim of the present study was...
Systemic synergism between codeine and morphine in three pain models in mice.
Background: The combination of two analgesic agents offers advantages in pain treatment. Codeine and morphine analgesia is due to activation of opioid receptor subtypes. Methods: This study, performed in mice using isobo...