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Correlation of the nalorphine test with concentration of metabolites of codeine in the urine after single doses and continuous administration of codeine
Author(s) -
Elliott Henry W.,
Nomof Norman,
Parker Kenneth D.
Publication year - 1967
Publication title -
clinical pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.941
H-Index - 188
eISSN - 1532-6535
pISSN - 0009-9236
DOI - 10.1002/cpt196781part178
Subject(s) - nalorphine , codeine , morphine , miosis , urine , metabolite , anesthesia , pharmacology , pupil , medicine , chemistry , opioid , (+) naloxone , psychology , receptor , neuroscience
Single doses of codeine cause miosis which is not reversed by nalorphine, as the miosis with other morphinelike drugs is. When codeine was given four times a day, most subjects gave positive nalorphine (pupil) tests on the third day. Urinalysis for codeine and its metabolite morphine revealed that subjects with the highest urine drug levels had the most strongly positive pupil tests, but the gradual development of a positive pupil test was not related to increasing concentrations of morphine in the urine. When codeine was infused continuously (30 mg. per hour) to produce “acute tolerance,” the pupil test was positive in 8 hours. In the dog, a species which forms norcodeine but not morphine from codeine, the pupil test was negative after a single injection of codeine but became positive after 2 to 3 days of intermittent injections. The data suggest that positive nalorphine tests occur only in subjects tolerant to codeine.