在新生儿代谢和药物动力学的吗啡:审查。
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在新生儿代谢和药物动力学的吗啡:审查。
诊所(圣保罗)。2016年8月,71 (8):474 - 80。doi: 10.6061 /诊所/ 2016 (08)11。
- PubMed ID
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27626479 (在PubMed]
- 文摘
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吗啡是微观和k的受体激动剂受体,激活的镇痛。类吗啡受体激动剂通过微观阿片受体引起疼痛,镇静、兴奋和呼吸萧条。吗啡是glucuronidated和硫酸在位置3和6;等离子体浓度与出生体重比率正相关,这可能反映出肝脏重量增加,与出生体重增加。此外,吗啡间隙积极与胎龄和出生体重相关。稳态等离子体吗啡浓度后24 - 48小时的输液,但是葡糖苷酸代谢物等离子体浓度没有达到稳态前60个小时。morphine-3-glucuronide代谢物的间隙较低,半衰期短,体积更小的分布与morphine-6代谢物相比,这是最活跃的类吗啡受体激动剂。普通剂量引起便秘、尿潴留和呼吸萧条。新生儿疼痛可能需要大约120纳克/毫升的血液水平,而低水平(20 - 40 ng / ml)似乎适合孩子。文献搜索使用PubMed数据库和执行关键字“吗啡代谢新生儿”和“吗啡药物动力学新生儿”。 The initial and final cutoff points were January 1990 and September 2015, respectively. The results indicate that morphine is extensively glucuronidated and sulfated at positions 3 and 6, and that the glucuronidation rate is lower in younger neonates compared with older infants. Although much is known about morphine in neonates, further research will be required to ensure that recommended therapeutic doses for analgesia in neonates are evidence based.
