The use of opioid analgesics in renal dysfunction is potentially problematic and many patients with end stage renal disease are unable to tolerate these medications. A greater understanding of the pharmacokinetics of opioid analgesics is vital in informing safe and effective practice.
Using pharmacokinetic analysis, this case study demonstrates for the first time that oxycodone and its metabolites are removed by haemodialysis. As such, care should be taken when using oxycodone in patients undergoing haemodialysis.
Davies G , Kingswood C , Street M . Pharmacokinetics of opioids in renal dysfunction . Clin Pharmacokinet1996; 31: 410–422 .
2.
Guay DRP , Awni WM , Findlay JWA , et al. Pharmacokinetics and pharmacodynamics of codeine in end-stage renal disease . Clin Pharmacol Ther1988; 43: 63–71 .
3.
Sear JW , Hand CW , Moore RA , McQuay HJ . Studies on morphine disposition: influence of renal failure on the kinetics of morphine and its metabolites . Br J Anaesth1989; 62: 28–32 .
4.
Osbourne RJ , Joel SP , Slevin ML . Morphine intoxication in renal failure: the role of morphine-6-glucuronide . Br Med J1986; 292: 1548–1549 .
5.
Kirvela M , Lindgren L , Seppala T , Olkkola KT . The pharmacokinetics of oxycodone in uraemic patients undergoing renal transplantations . J Clin Anesth1996; 8: 13–18 .
6.
Bion JF , Logan BK , Newman PM , et al. Sedation in intensive care: morphine and renal function . Intensive Care Med1986; 12: 359–365 .
7.
Bastani B , Jamal JA . Removal of morphine but not fentanyl during haemodialysis . Nephrol Dial Transplant1997; 12: 2802–2804 .
8.
Neuman HP , Bender BU , Berger DP , et al. Prevalence, morphology and biology of renal cell carcinoma in von Hippel-Lindau disease compared to sporadic renal cell carcinoma . J Urol1998; 160: 1248–1254 .