More Codeine Fatalities After Tonsillectomy in North American Children

被引：257

作者：

Kelly, Lauren E. ^{[2
,3
,4
]}

Rieder, Michael ^{[2
,4
]}

van den Anker, John ^{[5
]}

Malkin, Becky ^{[4
]}

Ross, Colin ^{[6
]}

Neely, Michael N. ^{[7
]}

Carleton, Bruce ^{[6
,8
]}

Hayden, Michael R. ^{[6
]}

Madadi, Parvaz ^{[1
,9
]}

Koren, Gideon ^{[1
,3
,9
]}

机构：

[1] Hosp Sick Children, Div Clin Pharmacol & Toxicol, Toronto, ON M5G 1X8, Canada

[2] Univ Western Ontario, Schulich Sch Med, London, ON, Canada

[3] Univ Western Ontario, Ivey Chair Mol Toxicol, London, ON, Canada

[4] London Hlth Sci Ctr, Dept Clin Pharmacol, London, ON, Canada

[5] Childrens Natl Med Ctr, Ctr Clin & Community Res, Washington, DC 20010 USA

[6] Univ British Columbia, Ctr Mol Med & Therapeut, Vancouver, BC V5Z 1M9, Canada

[7] Univ So Calif, Commun Sci Inst, Los Angeles, CA USA

[8] Child & Family Res Inst, Vancouver, BC, Canada

[9] Univ Toronto, Dept Clin Pharmacol, Toronto, ON, Canada

来源：

PEDIATRICS | 2012年 / 129卷 / 05期

关键词：

codeine; tonsillectomy; sleep apnea; OBSTRUCTIVE SLEEP-APNEA; MORPHINE; GENOTYPE; PAIN;

D O I：

10.1542/peds.2011-2538

中图分类号：

R72 [儿科学];

学科分类号：

100202 ;

摘要：

In 2009 we reported the fatal case of a toddler who had received codeine after adenotonsillectomy for obstructive sleep apnea syndrome. The child was an ultra-rapid metabolizer of cytochrome P4502D6 (CYP2D6). We now report 3 additional fatal or life-threatening cases from North America. In the 2 fatal cases, functional gene duplications encoding for CYP2D6 caused a significantly greater production of potent morphine from its parent drug, codeine. A severe case of respiratory depression in an extensive metabolizer is also noted. These cases demonstrate that analgesia with codeine or other opioids that use the CYP2D6 pathway after adenotonsillectomy may not be safe in young children with obstructive sleep apnea syndrome. Pediatrics 2012;129:e1343-e1347

引用

页码：E1343 / E1347

页数：5

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