Hydromorphone: pharmacology and clinical applications in cancer patients

@article{Sarhill2001HydromorphonePA,
  title={Hydromorphone: pharmacology and clinical applications in cancer patients},
  author={Nabeel Sarhill and Declan Walsh and Kristine A. Nelson},
  journal={Supportive Care in Cancer},
  year={2001},
  volume={9},
  pages={84-96}
}
Abstract Hydromorphone is a more potent opioid analgesic than morphine and is used for moderate to severe pain. It can be administered by injection, by infusion, by mouth, and rectally. Oral bioavailability is low. The kidney excretes hydromorphone and its metabolites. Some metabolites may have greater analgesic activity than hydromorphone itself but are unlikely to contribute to the pharmacological activity of hydromorphone. With the exception of pruritus, sedation and nausea and vomiting… 
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References

SHOWING 1-10 OF 131 REFERENCES
Clinical pharmacokinetics of morphine.
TLDR
Morphine (M) is recommended by the World Health Organization as the treatment of choice for moderate-to-severe cancer pain and is formed to a greater extent after oral administration; it is not, however, usually found in plasma.
Absolute Bioavailability of Hydromorphone After Peroral and Rectal Administration in Humans: Saliva/Plasma Ratio and Clinical Effects
TLDR
The saliva sampling for the hydromorphone concentration was found to be a useful noninvasive technique for the estimation of the elimination half‐life of hydromOrphone.
The mode of action of promethazine in potentiating narcotic drugs.
TLDR
Promethazine premedication should be reserved for situations where the use of intravenous anaesthetics is anticipated and may prove to be a useful drug in certain other situations where too rapid inactivation of the principal drug presents a therapeutic problem.
Equianalgesic dose/ratio between methadone and other opioid agonists in cancer pain: comparison of two clinical experiences.
TLDR
The fact that methadone ratio is different according to the opioid dose used previously should be taken into careful consideration by the clinician in order to avoid severe toxicity or death during switchover.
Transdermal fentanyl: suggested recommendations for clinical use.
  • R. Payne
  • Medicine, Biology
    Journal of pain and symptom management
  • 1992
The Pharmacokinetics of Heroin in Patients with Chronic Pain
TLDR
It is concluded that heroin is a pro-drug that serves to determine the distribution of its active metabolites and that oral heroin is converted to morphine and appears to be an inefficient means of providing morphine to the systemic circulation.
...
...