Stability and compatibility of intrathecal admixtures containing baclofen and high concentrations of morphine

International Journal of Pharmaceutics

Volumn 153, Issue 1, 1997, Pages 13-24

  Sitaram, Balvant R ^b   Tsui, Michael ^a   Rawicki, H Barry ^a   Lam, Skip ^a   Sitaram, Manjula ^b  

^a Caulfield General Medical Centre   (Australia)

^b MONASH UNIVERSITY   (Australia)

Author keywords

Admixture; Baclofen; Compatibility; Intrathecal; Morphine; Pseudomorphine; Stability

Indexed keywords

BACLOFEN; MORPHINE;

ARTICLE; DRUG DEGRADATION; DRUG INCOMPATIBILITY; DRUG MIXTURE; DRUG STABILITY; LIQUID CHROMATOGRAPHY; PRIORITY JOURNAL; STORAGE; TEMPERATURE;

EID: 0030832340     PISSN: 03785173     EISSN: None     Source Type: Journal    
DOI: 10.1016/S0378-5173(97)04926-0     Document Type: Article

References (29)

1. Abel, N.A., Smith, R.A., 1994. Intrathecal baclofen for treatment of intractable spasticity. Arch. Phys. Med. Rehab. 75, 54-58.
2. Ahuja, S., 1985. Baclofen. In: Klaus Florey (Ed.), Analytical Profiles of Drug Substances, Academic Press Inc., New York, Vol. 14, pp. 527-548.
3. Armstrong, R.W., Sykanda, A., Steinbok, P., Farrell, K., 1987. A pilot study of intrathecal baclofen for treatment of spasticity in children. Dev. Med. and Child Neurol. 2 (55), 23-24.
4. Coombs, D.W., Saunders, R.L., Lachance, D., Savage, S., Ragnarsson, T.S., Jensen, L.E., 1985. Intrathecal morphine tolerance: use of intrathecal clonidine. DADLE and intraventricular morphine. Anesthesiology 62, 358-363.
5. Cutler, R.P.W., Page, L., Galicich, J., Watters, G.V., 1968. Formation and absorption of CSF in man. Brain 91, 707-720.
6. Darwin, W.D., Cone, E.J., 1980. Fluorescence properties of pseudomorphine and congeners: structure-activity relationships. J. Pharmaceutical Sci. 69, 253-257.
7. Dolezalova, M., 1992. Ion-pair high-performance liquid Chromatographic determination of morphine and pseudomorphine in injections. J. Pharmaceutics Biomed. Anal. 10, 507-514.
8. Dralle, D., Muller, J., Zierski, J., Klug, N., 1985. Intrathecal baclofen for spasticity. Lancet, ii, 1003.
9. Erickson, D.L., Blacklock, J.B., Michaelson, M., Sperling, K.B., Lo, J.N., 1985. Control of spasticity by implantable continuous flow morphine pump. Neurosurgery 16, 215-217.
10. Follett, K.A., Hitchon, P.W., Piper, J., Kumar, V., Clamon, G., Jones, M.P., 1992. Response of intractable pain to continuous intrathecal morphine: a retrospective study. Pain 49, 21-25.
11. Forman, D.T., Changus, G.C., 1967. An automated osmometer. Clin. Chem. 38, 38-46.
12. Hankey, G.J., Stewart-Wynne, E.G., Perlman, D., 1987. Intrathecal baclofen for severe spasticity. Med. J. Aust. 147, 261.
13. Krames, E.S., Gershow, J., Glassberg, A., Kenefick, T., Lyons, A., Taylor, P., Wilkie, D., 1985. Continuous infusion of spinally administered narcotics for the relief of pain due to malignant disorders. Cancer 56, 696-702.
14. Milne, B., Cervenko, F., Jhamandas, K., Loomis, C., Sutak, M., 1985. Analgesia and tolerance to intrathecal morphine and norepinephrine infusion via implanted mini-osmotic pumps in the rat. Pain 22, 165-172.
15. Muller, H., Zierski, J., Dralle, D., Borner, U., Hoffman, O., 1987. The effect of intrathecal baclofen on electrical muscle activity in spasticity. J. Neurol. 234, 348-352.
16. Ochs, G., Struppler, A., Meyerson, B.A., Linderoth, B., Gybels, J., Gardner, B.P., Teddy, P., Jamous, A., Weinman, P., 1989. Intrathecal baclofen for long term treatment of spasticity: a multicentre study. J. Neurol. Neurosurg. and Psychiatry 52, 933-939.
17. Onofrio, B.M., Yaksh, T.L., Arnold, P.G., 1981. Continuous low dose intrathecal morphine administration in the treatment of chronic pain of malignant origin. Mayo. Clin. Proc. 56, 516-520.
18. Parke, B., Penn, R.D., Savoy, S.M., Corcos, D., 1989. Functional outcome after delivery of intrathecal baclofen. Arch. Phys. Med. Rehabil. 70, 30-32.
19. Penn, R.D., Kroin, J.S., 1984. Intrathecal baclofen alleviates spinal cord spasticity. Lancet, i, 1078.
20. Penn, R.D., Kroin, J.S., 1985. Continuous intrathecal baclofen for severe spasticity. Lancet, ii, 125-127.
21. Penn, R.D., Paice, J.A., 1987. Chronic intrathecal morphine for intractable pain. J. Neurosurg. 67, 182-186.
22. Penn, R.D., 1988. Intrathecal baclofen for severe spasticity. Ann. N.Y. Acad. Sci. 531, 157-166.
23. Penn, R.D., 1992. Intrathecal baclofen for spasticity of spinal origin: seven years of experience. J. Neurosurg. 77, 236-240.
24. Rawicki, H.B., Sitaram, B.R., Tsui, M., Lam, S., Courage, P., 1994a. In vivo and in vitro combination of baclofen and morphine for intrathecal use in severe spasticity and chronic pain. Unpublished data, presented at the International Medical Society of Paraplegia (IMSOP) Regional Scientific Meeting, Melbourne 12-13 May 1994.
25. Rawicki, H.B., Sitaram, B.R., Tsui, M., Lam, S., Courage, P., 1994b. In vivo and in vitro combination of baclofen and morphine for intrathecal use in severe spasticity and chronic pain. Unpublished data, presented at the International Neuromodulation Society Scientific Meeting, Gotberg, Sweden. 2-4 June 1994.
26. Sitaram, B.R., Tsui, M., Rawicki, H.B., Lam, S., Courage, P., Sitaram, M., Chapman, C.B., 1995. Stability and compatibility of baclofen and morphine admixtures for use in an implantable infusion pump. Intern. J. Pharmaceutics 118, 181-189.
27. CO2 in human cerebrospinal fluid. Clin Chim Acta. 6, 589-590.
28. Yaksh, T. L, Rudy, T.A., 1978. Narcotic analgesics, CNS sites and mechanisms of action as revealed by intracere-bral injection techniques. Pain 4, 299-359.
29. Yeh, S., Lach, J.L., 1961. Stability of morphine in aqueous solution III. Kinetics of morphine degradation in aqueous solution. J. Pharm. Sci. 50, 35-42.