TY - JOUR PY - 2012// TI - More Codeine Fatalities After Tonsillectomy in North American Children JO - Pediatrics A1 - Kelly, Lauren E. A1 - Rieder, Michael A1 - van den Anker, John A1 - Malkin, Becky A1 - Ross, Colin A1 - Neely, Michael N. A1 - Carleton, Bruce A1 - Hayden, Michael R. A1 - Madadi, Parvaz A1 - Koren, Gideon SP - e1343 EP - 7 VL - 129 IS - 5 N2 - 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.
Language: en
LA - en SN - 0031-4005 UR - http://dx.doi.org/10.1542/peds.2011-2538 ID - ref1 ER -