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Codeine metabolism in children





Codeine in Young Children Linked to Serious Adverse Events

02/05/2015
08:36 | Author: Emily Peterson

Codeine metabolism time
Codeine in Young Children Linked to Serious Adverse Events

This enzyme converts codeine into morphine, but the genetic variation carried by these children speeds up that metabolism, resulting in.

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Pharmacogenetics of codeine metabolism in an urban population of

02/05/2015
06:12 | Author: Alex Watson

Codeine metabolism in children
Pharmacogenetics of codeine metabolism in an urban population of

Br J Anaesth. 2002 Dec;89(6):839-45. Pharmacogenetics of codeine metabolism in an urban population of children and its implications for analgesic reliability.

Ninety-six children received either codeine 1.5 mg kg(-1) or morphine 0.15 mg kg(-1) in a randomized, double-blind design. Genetic analysis was performed and plasma morphine concentrations at 1 h were determined. Postoperative analgesia and side-effects were recorded.

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Reduced ability for codeine metabolism may be more common than previously reported. Plasma morphine concentration 1 h after codeine is very low, and related to phenotype. Codeine analgesia is less reliable than morphine, but was not well correlated with either phenotype or plasma morphine in this study.

Codeine analgesia is wholly or mostly due to its metabolism to morphine by the cytochrome P450 enzyme CYP2D6, which shows significant genetic variation in activity. The aims of this study were to investigate genotype, phenotype and morphine production from codeine in children undergoing adenotonsillectomy, and to compare analgesia from codeine or morphine combined with diclofenac.

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Forty-seven per cent of children had genotypes associated with reduced enzyme activity. Mean (SD) morphine concentrations were significantly lower (P<0.001) after codeine than after morphine, and morphine and its metabolites were not detected in 36% of children given codeine. There was a significant relationship between phenotype and plasma morphine (P=0.02). More children required rescue analgesia after codeine at both 2 (P<0.05) and 4 h after administration (P<0.01). Fifty-six per cent of children vomited after morphine and 29% after codeine (P<0.01). Neither phenotype nor morphine concentration was correlated with either pain score or the need for rescue analgesia (r=-0.21, 95% confidence interval -0.4, -0.01).

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New FDA Black Box Warning for Codeine How Will This Affect

02/05/2015
04:32 | Author: Hannah Ramirez

Codeine metabolism in children
New FDA Black Box Warning for Codeine How Will This Affect

Despite less than impressive evidence to impugn ultrarapid metabolism of codeine as a cause of morphine overdose in these children, rather than excessive.

There is sound evidence that nonsteroidal anti-inflammatory analgesics and acetaminophen provide excellent postoperative analgesia and should be considered for all children who are at risk for OSA, even if they have not been diagnosed with it. We need to consider the risk:benefit ratio of prescribing opioids versus nonopioid alternatives for all children and especially for those at risk for OSA, since opioids increase the risk of precipitating life-threatening events when the child is at home. We also need to take extra time to ensure to the best of our ability that the parent or caregiver fully understands that he or she cannot administer more than the prescribed dose of an analgesic and inform them of the potential adverse consequences of giving more than the prescribed dose or giving the next dose too soon after the previous dose.

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It39s time to rethink use of codeine in pediatric patients - AAP News

02/05/2015
02:04 | Author: Hannah Ramirez

Codeine metabolism in children
It39s time to rethink use of codeine in pediatric patients - AAP News

It's time to rethink use of codeine in pediatric patients 46% of children had phenotypes of CYP2D6 associated with decreased metabolism of.

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Pharmacogenetics of codeine metabolism in an urban population of

02/05/2015
12:20 | Author: Alex Watson

Methadone
Pharmacogenetics of codeine metabolism in an urban population of

PHARMACOKINETIC MODEL DRIVEN INFUSION OF PROPOFOL IN CHILDREN; Major complications of airway management in the UK: results of the Fourth.

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