Research Article
Plasma Concentration of Oxycodone and Pain during Hemodialysis in a Patient with Cancer
Satoshi Murakami1, Mizuki Herai2, Satoshi Suzuki 3, Takayuki Fujii3, Hiroaki Tanaka3, Mizuki Shinozaki3, Hideya Kokubun4, Toru Akagi5, Yasuhito Uezono6,7, Yuko Murakami-Ando8, Seiji Shiraishi6,9, Motohiro Matoba10*1Department of Palliative Medicine, Seirei Sakura Citizen Hospital, Chiba, Japan
2Department of Nursing, Seirei Sakura Citizen Hospital, Chiba, Japan
3Department of Internal Medicine, Seirei Sakura Citizen Hospital, Chiba, Japan
4Department of Pharmacy, Kitasato University Hospital, Kanagawa, Japan
5Department of Pharmacy, National Cancer Center Hospital, Tokyo, Japan
6Cancer Pathophysiology Division, National Cancer Center Research Institute, Tokyo, Japan
7Division of Supportive Care Research, Exploratory Oncology Research & Clinical Trial Center, Tokyo, Japan
8Department of Anesthesia, Iwai Orthopaedic Medical Hospital, Tokyo, Japan
9Department of Anesthesia and Intensive Care, National Cancer Center Hospital, Tokyo, Japan
10Department of Palliative Care, Japanese Red Cross Medical Center, Tokyo, Japan
- *Corresponding Author:
- Motohiro Matoba, M.D., PhD
Department of Palliative Care
Japanese Red Cross Medical Center
4-1-22 Hiroo, Shibuya-ku
Tokyo 150-8935, Japan
Tel: +81-3-3400-1311
Fax: +81-3-3409-1604
E-mail: teamkanwa@gmail.com
Received date: Feb 15, 2016; Accepted date: Mar 09, 2016; Published date: Mar 12, 2016
Citation: Murakami S, Herai M, Suzuki S, Fujii T, Tanaka H, et al. (2016) Plasma Concentration of Oxycodone and Pain during Hemodialysis in a Patient with Cancer. J Palliat Care Med 6:252. doi:10.4172/2165-7386.1000252
Copyright: © 2016 Murakami S, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Abstract
Pain is one of the most common problems in palliative medicine, and opioid therapy should be used adequately. Clinically, many cancer patients with severe renal dysfunction receive opioids for pain control. However, the pharmacokinetics of opioids during hemodialysis are not completely understood. We investigated the time course of the plasma concentration of oxycodone and pain during hemodialysis in a 55-year-old man using oxycodone for cancer pain. The patient’s plasma concentration of oxycodone decreased during hemodialysis, and increased after it ended. Conversely, his pain increased after the beginning of hemodialysis, and improved after it was finished. Additionally, our results did not show a relationship between the plasma concentration of oxycodone and his pain. Breakthrough pain occurred several times during hemodialysis irrespective of the plasma concentration of oxycodone. The decrease in plasma oxycodone during hemodialysis appeared to be caused by the removal of oxycodone by hemodialysis, and the later increase after hemodialysis appeared to be related to the redistribution of oxycodone. On the other hand, breakthrough pain during hemodialysis may be caused by hemodialysis itself, rather than due to the decrease of the plasma concentration of oxycodone, given that no relationship between the plasma concentration of oxycodone and pain could be identified. When building a strategy of pain management during hemodialysis, both the possibilities of a decrease in the plasma concentration of oxycodone by hemodialysis and the increase of pain by hemodialysis itself should be considered.
