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首页> 外文期刊>The Journal of Clinical Pharmacology: Official Journal of the American College of Clinical Pharmacology >Switching Opioid-Dependent Patients From Methadone to Morphine: Safety, Tolerability, and Methadone Pharmacokinetics
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Switching Opioid-Dependent Patients From Methadone to Morphine: Safety, Tolerability, and Methadone Pharmacokinetics

机译：将阿片类药物依赖性患者从美沙酮改为吗啡：安全性，耐受性和美沙酮药代动力学

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The aim of this study was to switch patients established on methadone opioid substitution therapy (OST) to morphine over 1 week. Subjects established on daily methadone OST (mean dose 60 mg/day) were switched to morphine slow-release capsules, dosed at 4x the previous total daily methadone dose, for 6 days, then given morphine syrup dosed q3h. All 27 subjects enrolled in this study completed the switch from methadone to morphine. Opioid withdrawal symptoms (OWS) peaked within 12-24 hours of starting morphine, and 24/27 subjects required higher daily morphine doses (mean 5.2x multiple). Pharmacokinetic evaluation showed that 91% of methadone was cleared during this time, with a mean elimination half-life of 59 hours. The most frequent treatment-emergent non-OWS adverse events were headache, nausea, constipation, and neck pain. The method described here appears to be a safe and acceptable approach to switch subjects from methadone to morphine.
机译：这项研究的目的是在1周内将使用美沙酮阿片类药物替代疗法（OST）的患者转为使用吗啡。将以美沙酮每日OST（平均剂量60毫克/天）确定的受试者换成吗啡缓释胶囊，剂量为先前总美沙酮每日剂量的4倍，持续6天，然后每3h服用一次吗啡糖浆。参加这项研究的所有27位受试者都完成了从美沙酮到吗啡的转换。阿片类药物戒断症状（OWS）在开始使用吗啡的12-24小时内达到高峰，而24/27名受试者需要更高的每日吗啡剂量（平均5.2倍）。药代动力学评估表明，在此期间清除了91％的美沙酮，平均消除半衰期为59小时。最紧急的非OWS紧急治疗不良事件是头痛，恶心，便秘和颈部疼痛。这里描述的方法似乎是将受试者从美沙酮转到吗啡的安全且可接受的方法。

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