morphine-6-glucuronide and Respiration-Disorders

Though many of the treatment strategies used in palliative care have never been subjected to clinical trial, it has been argued that advances in palliative care have outstripped those in many other specialties. This article is not a comprehensive review of therapeutic options, nor even of recent advances in this topic, but concentrates on the latest developments and controversies in the pharmacological treatment of four frequent and important symptoms: neuropathic pain, anorexia and cachexia, intestinal obstruction, and breathlessness. It is difficult to perform blinded, randomised trials in patients with advanced disease and poor performance status, yet it is these patients who may gain most from the adoption of new well evaluated treatment strategies.

Topics: Anorexia; Anti-Inflammatory Agents, Non-Steroidal; Cachexia; Humans; Intestinal Obstruction; Morphine Derivatives; Neoplasms; Pain; Palliative Care; Respiration Disorders

We report a case of long lasting respiratory depression after intravenous administration of morphine to a 7 year old girl with haemolytic uraemic syndrome. The plasma concentrations of the active metabolite M6G were more than 10 times those normally seen and the half-lives of M6G and morphine were prolonged.

Topics: Child; Depression, Chemical; Female; Hemolytic-Uremic Syndrome; Humans; Morphine Derivatives; Pain, Postoperative; Respiration Disorders