Update 1990 pp 770-779 | Cite as

Liver Metabolism of Analgesic Agents

  • G. R. Park
  • K. Quinn
Conference paper
Part of the Update in Intensive Care and Emergency Medicine book series (UICM, volume 10)

Abstract

The importance of the liver in the metabolism of analgesic agents has long been recognized. Important changes in the elimination of these drugs may occur in critically ill patients. Changes in liver blood flow are particularly important since hypotension, anesthesia and surgery [1], trauma, sepsis, hypoxia and possibly inotropic therapy lead to significant alterations, resulting in large changes in the clearance of these drugs. To date there has been little systematic study of commonly used drugs in acute hepatic insufficiency, a common accompaniment of serious illness. Furthermore the concurrent administration of some of the many drugs used to treat such illness including benzodiazepines, cimetidine etc. may interfere with the liver enzymatic activity, decreasing or increasing the rate of metabolism. Of all of the analgesics in common use in the critically ill, morphine is the commonest in use worldwide. This review will predominately concentrate on the altered metabolism of morphine in critically ill humans although the newer synthetic opiates will also be discussed.

Keywords

High Performance Liquid Chromatography Alkaloid Fentanyl Cimetidine Schistosomiasis 

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Copyright information

© Springer-Verlag Berlin Heidelberg 1990

Authors and Affiliations

  • G. R. Park
  • K. Quinn

There are no affiliations available

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