1 / 11

Intrathecal Delivery of Morphine

November 4, 2010 Jaimie M. Stewart In Collaboration with: Ying Hsu Advisor: Professor Andreas A. Linninger Laboratory for Product and Process Design Department of Bioengineering University of Illinois, Chicago, IL. Intrathecal Delivery of Morphine. Morphine. Potent opiate analgesic.

yehuda
Download Presentation

Intrathecal Delivery of Morphine

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. November 4, 2010 Jaimie M. Stewart In Collaboration with: Ying Hsu Advisor: Professor Andreas A. Linninger Laboratory for Product and Process Design Department of Bioengineering University of Illinois, Chicago, IL Intrathecal Delivery of Morphine

  2. Morphine • Potent opiate analgesic. • Used to relieve severe pain. • Can be taken orally, rectally, subcutaneously, intravenously, intrathecally or epidurally. • Binds to μ-opioid receptors. • Located through out the brain and spinal cord.

  3. μ-opioid receptor locations

  4. μ-opioid receptor locations

  5. Toxicity of Morphine • Can be caused due to an allergic reaction or overdose. • Symptoms • Respiratory depression • Hypotension • Circulatory failure • Coma • Convulsions • Rhabdomylosis (Destruction of striated muscle fibers) • Renal failure

  6. Why Administer Morphine Intrathecally? • Morphine is subject to extensive first-pass metabolism. • If taken orally only 40–50% of the dose reaches the central nervous system. • Subcutaneous, intramuscular, and Intravenous injection administrations peak in the body from 20 to 30 minutes. • Morphine crosses the blood-brain barrier, but not easily. • This is due to poor lipid solubility, protein binding, fast conjoinment with glucuronic acid, and ionization.

  7. Case 1 • 5 cancer patients with sever, intractable pain in the lower half of the body. • Intrathecal administration (L5-S1) of 2 mg morphine in 2 forms: (1) isobaric (NaCl 0.9%) and (2) hyperbaric solution (7% dextrose). • CSF was collected at T10,then CSF morphine levels were determined by HPLC.

  8. Case 2 • Morphine was administered through a 25-gauge spinal needle at L3-L4 • Morphine was injected in 2ml saline solution followed by a 1 ml saline solution flush. • CSF morphine concentrations were determined by measuring CSF at the C1-2 level.

  9. Goals • Morphine infusion case study based on a clinical trial: • Morphine concentration field • Morphine delivery into the spinal cord • Therapeutic effect and toxicity

  10. Questions?

  11. References "MS-Contin (Morphine Sulfate Controlled-Release) Drug Information: User Reviews, Side Effects, Drug Interactions and Dosage at RxList." Web. 02 Nov. 2010. <http://www.rxlist.com/ms-contin-drug.htm#cp>. "Morphine Toxicity Symptoms, Diagnosis, Treatments and Causes - WrongDiagnosis.com." Wrong Diagnosis. Web. 02 Nov. 2010. <http://www.wrongdiagnosis.com/m/morphine_toxicity/intro.htm>. Caute, B., B. Monsarrat, C. Gouarderes, J.C. Verdie, Y. Lazorthes, J. Cros, and R. Bastide. "CSF Morphine Levels after Lumbar Intrathecal Administration of Isobaric and Hyperbaric Solutions for Cancer Pain." Pain 32.2 (1988): 141-46. Print Max, Mitchell B., Charles E. Inturrisi, Robert F. Kaiko, Patricia Y. Grabinski, Choh H. Li, and Kathleen M. Foley. "Clinical Pharmacology & Therapeutics - Abstract of Article: Epidural and Intrathecal Opiates: Cerebrospinal Fluid and Plasma Profiles in Patients with Chronic Cancer Pain." Nature Publishing Group : Science Journals, Jobs, and Information. Web. 02 Nov. 2010. <http://www.nature.com/clpt/journal/v38/n6/abs/clpt1985237a.html>. "Pain Processes - 1." Georgia Pain Physicians, P.C. Web. 03 Nov. 2010. <http://www.georgiapainphysicians.com/l2_edu_pharma_mod1_slides.htm>.

More Related