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Codeine metabolism polymorphism





The Dangers of Codeine and CYP2D6 Polymorphisms in Pediatric

02/05/2015
04:13 | Author: Sarah Gray

Codeine metabolism time
The Dangers of Codeine and CYP2D6 Polymorphisms in Pediatric

Codeine is a pro-drug in which analgesic properties are dependent on its metabolism to active morphine through the cytochrome P450 2D6.

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Polymorphic metabolism of opioid narcotic drugs possible clinical

02/05/2015
02:14 | Author: Hannah Ramirez

Codeine metabolism rate
Polymorphic metabolism of opioid narcotic drugs possible clinical

Polymorphic metabolism of opioid narcotic drugs: possible clinical implications. The hepatic O-demethylation of codeine to morphine, quantitatively a minor.

The oxidative metabolism of many drugs is under genetic control. The enzyme responsible for this reaction for this group of drugs is cytochrome P-450IID6. Humans can be classified either as extensive metabolisers or, if lacking this enzyme, poor metabolisers. The incidence of poor metabolisers in caucasian subjects is 7-10%. The hepatic O-demethylation of codeine to morphine, quantitatively a minor metabolic process, represents this type of genetic polymorphism and has been studied in human pharmacokinetic studies, human urinary recovery studies, and in human and rat liver microsome experiments. Based on the current understanding that the analgesic effect of codeine is mediated primarily through morphine, one might anticipate that poor metabolisers would not obtain pain relief from codeine. The clinical significance of this polymorphism to the antidiarrhoeal and antitussive properties of codeine is not known. Others opioids (dihydrocodeine, hydrocodone, oxycodone, and thebaine) are structurally similar to codeine and their metabolism (O-demethylation at the 3 position) might also be under genetic control. Pharmacogenetics may play an important role in explaining the wide variability of the clinical response to many opioid drugs.

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Genetic Polymorphism and ToxicologyWith Emphasis on

02/05/2015
12:21 | Author: Ryan Brooks

Codeine metabolism time
Genetic Polymorphism and ToxicologyWith Emphasis on

This polymorphism is in particular translated into risk differences concerning drugs. Morphine Toxicity—Ultrarapid Metabolism of Codeine.

A case report from 2006 describes two patients who experienced acute dystonic reactions when receiving the antiemetic drug metoclopramide ( van der Padt et al., 2006 ). Genetic analysis revealed that both patients were CYP2D6 PM. Metoclopramide is known to be both a substrate and an inhibitor of CYP2D6, and extrapyramidal syndrome (EPS) because of treatment with this drug has been observed in 1/500 patients. Drug-induced EPS is more frequently found in patients deficient in CYP2D6, and therefore, metoclopramide probably should be avoided in patients at risk of acute dystonic reactions ( van der Padt et al., 2006 ).

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Why Codeine is Dangerous in Some Kids After Tonsillectomy - Forbes

02/05/2015
02:08 | Author: Hannah Ramirez

Methadone
Why Codeine is Dangerous in Some Kids After Tonsillectomy - Forbes

The CYP2D6 polymorphisms that cause some ultra-rapid codeine metabolism are among the SNPs detected. However, these kits don't detect.

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A new Boxed Warning, FDA’s strongest warning, will be added to the drug label of codeine-containing products about the risk of codeine in post-operative pain management in children following tonsillectomy and/or adenoidectomy. A Contraindication, which is a formal means for FDA to make a strong recommendation against use of a drug in certain patients, will be added to restrict codeine from being used in this setting.

So why are some kids more sensitive to codeine?

Some consumer DNA typing services include this variation in CYP2D6 in their screening set.

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What alternatives to codeine are available for post-tonsillectomy and

02/05/2015
04:25 | Author: Sarah Gray

Methadone
What alternatives to codeine are available for post-tonsillectomy and

Codeine metabolism and CYP2D6 polymorphism. Codeine has minimal affinity for mu-opioid receptors and its analgesic effect depends on metabolism to.

Tonsillectomy, adenoidectomy, and pain.

A 2-year-old male with a history of snoring and sleep study-confirmed OSA underwent elective AT.3 The outpatient procedure was uncomplicated, and the patient received intramuscular doses of 10 mg of meperidine and 12.5 mg of dimenhydrinate 6 hours after surgery. The patient was then sent home with instructions for the oral administration of 10 to 12.5 mg of codeine and 120 mg of acetaminophen syrup every 4 to 6 hours as needed for postoperative pain.

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