does dilaudid have active metabolites?

[Ferdie]

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I've looked at several different sources and have found conflicting information about whether hydromorphone has an active metabolite. In a few places I've read that HM3G is it's active metabolite, and in several other places (including the Merck Manual/Lexi-Comp) it says no active metabolites... It can't be both, so which is it. You guys use the stuff all the time, give me the right answer please!

 

[PMPMD]

maybe this will clear things up (by establishing that things are unclear.)

"Hydromorphone-3-glucuronide is thought to be pharmacologically inactive, but its inactivity has not been fully established." (p. 2)

Razaq M. Balicas M. Mankan N. Use of hydromorphone (Dilaudid) and morphine for patients with hepatic and renal impairment. [Case Reports. Journal Article] American Journal of Therapeutics. 14(4):414-6, 2007 Jul-Aug.

 

[Ferdie]

Thanks for the reply.

This makes me mad. I had my last exam of med school today - an independent study class where the exam is the same as the practice test stems they give you. Well, one of the questions on the exam today was "which of the following narcotics has no active metabolite:" and the options were morphine, codeine, hydromorphone, and propoxyphene.

I don't think there's any clearly correct answer to that question.

 

[Ferdie]

whatever, med school's done, I'm drinking (awful) champagne, and I'm pretty sure I passed the test regardless of it being asinine.

 

[PMPMD]

whatever, med school's done, I'm drinking (awful) champagne, and I'm pretty sure I passed the test regardless of it being asinine.

is it Andre?

 

[lobelsteve]

Hydromorphone has no active metabolites
Morphine goes to m3g and m6g and sometimes codeine
Codeine goes to hydrocodone and morphine
Propoxyphene become Nor-propoxyphene


Data from: Opioid Pharmacokinetics and Expected Metabolites (Updated 06-2005)
Data collected, collated, and organized by Jason Palmer, Pharm.D. Candidate / Revised, reviewed, & reformatted by Jeffrey Fudin,

 

[Bougie]

Stay the course pal. This too shall pass.

Most of the crap that I got worked up over in med school (unfair test questions, evaluation from peds neurology saying I was bored with the rotation, having a picture of me doing a keg stand at a med school party sent to our dean) was forgotten after the first week of internship.