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Breakthrough pain associated with a reduction in serum buprenorphine concentration during dialysis


Salili, Ali Reza; Müller, Daniel; Skendaj, Roswitha; Jehle, Andreas W; Taegtmeyer, Anne B (2016). Breakthrough pain associated with a reduction in serum buprenorphine concentration during dialysis. Clinical Therapeutics, 38(1):212-215.

Abstract

PURPOSE: To describe a case of breakthrough pain associated with a reduction in serum buprenorphine concentration during dialysis.
METHODS: Pharmacokinetic sampling of total and free buprenorphine and norbuprenorphine in an 80 year old male undergoing haemodialysis three times per week who received 5760 µg oral and transdermal buprenorphine daily was performed. The patient's serum albumin concentration was 23g/l (reference range: 35-52 g/l).
FINDINGS: Pharmacokinetic sampling revealed a free buprenorphine fraction of 32% (consistent with the hypoalbuminaemia), which was markedly reduced at the end of dialysis (free buprenorphine concentration 2.4 µg/l before vs. <0.1 µg/l after dialysis).
IMPLICATIONS: Clinicians should be aware that some patients may require extra buprenorphine doses during dialysis to prevent significant falls in the concentration of active drug.

Abstract

PURPOSE: To describe a case of breakthrough pain associated with a reduction in serum buprenorphine concentration during dialysis.
METHODS: Pharmacokinetic sampling of total and free buprenorphine and norbuprenorphine in an 80 year old male undergoing haemodialysis three times per week who received 5760 µg oral and transdermal buprenorphine daily was performed. The patient's serum albumin concentration was 23g/l (reference range: 35-52 g/l).
FINDINGS: Pharmacokinetic sampling revealed a free buprenorphine fraction of 32% (consistent with the hypoalbuminaemia), which was markedly reduced at the end of dialysis (free buprenorphine concentration 2.4 µg/l before vs. <0.1 µg/l after dialysis).
IMPLICATIONS: Clinicians should be aware that some patients may require extra buprenorphine doses during dialysis to prevent significant falls in the concentration of active drug.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Institute of Clinical Chemistry
Dewey Decimal Classification:610 Medicine & health
540 Chemistry
Language:English
Date:2016
Deposited On:17 Dec 2015 09:51
Last Modified:08 Dec 2017 15:42
Publisher:Excerpta Medica, Inc.
ISSN:0149-2918
Publisher DOI:https://doi.org/10.1016/j.clinthera.2015.10.009
PubMed ID:26572942

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