Features | Partner Sites | Information | LinkXpress
Sign In
GLOBETECH PUBLISHING
Schiller
Advantech Europe

Codeine Following Tonsillectomy Contraindicated in Children

By HospiMedica International staff writers
Posted on 07 Mar 2013
A new safety review shows that products that contain codeine should not be used for pain relief following tonsillectomy or adenoidectomy in children, due to a possible risk of serious adverse events.

The warning, issued by the US Food and Drug Administration (FDA; Silver Spring, MD, USA), is based on reports of three deaths and one life-threatening case of respiratory depression published in the medical literature following the use of codeine in children with obstructive sleep apnea (OSA) who underwent tonsillectomy or adenoidectomy. The children were determined to be ultra-rapid metabolizers, genetically susceptible to converting normal doses of codeine into dangerous levels of morphine in the body.

Following the reports, a review of the FDA's Adverse Event Reporting System from 1969 to May 1, 2012, and a physician survey conducted by the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS; Alexandria, VA, USA) uncovered a total of 12 deaths and three overdoses associated with codeine use in patients ranging in age from 21 months to 9 years. Eight of the cases involved codeine use after adenotonsillectomy, and three involved a respiratory tract infection. The codeine doses were appropriate in most cases.

“Since these children already had underlying breathing problems, they may have been particularly sensitive to the breathing difficulties that can result when codeine is converted in the body to high levels of morphine,” concluded the FDA advisory. “However, [the new] contraindication applies to all children undergoing tonsillectomy and/or adenoidectomy because it is not easy to determine which children might be ultra-rapid metabolizers of codeine.”

A boxed warning regarding the contraindication will be added to the labels of all codeine-containing products in the United States. The contraindication to codeine use does not apply to other types of pain management in children, although the FDA recommends that codeine should only be used if the benefits are anticipated to outweigh the risks.

Codeine (3-methylmorphine), a natural isomer of methylated morphine, is an opiate used for its analgesic, antitussive, antidiarrheal, antihypertensive, antianxiety, sedative, and hypnotic properties. It is used to suppress premature labor contractions, myocardial infarction (MI), cough suppression, as well as many other uses. Common adverse effects associated with the use of codeine include drowsiness, constipation, euphoria, itching, nausea, vomiting, and others. Rare adverse effects include anaphylaxis, seizure, and respiratory depression.

Related Links:

US Food and Drug Administration
American Academy of Otolaryngology-Head and Neck Surgery



Cincinnati Sub-Zero
Anetic Aid
ECR

Channels

Women's Health

view channel

Maternal Iron Intake Linked to Autism Risk

A new study reveals that mothers of children with autism spectrum disorder (ASD) are less likely to have taken iron supplements before and during their pregnancies. Researchers at the University of California Davis (UCD; USA) and the UCD Mind Institute Clinic (Sacramento, CA, USA) analyzed data from 866 mother-child... Read more

Health IT

view channel

Doctors Claim EHRs Do Not Save Money or Time

A recent survey claims that 75% of physicians in the United States who use electronic health records (EHRs) say they are not cost- or time-effective, but do have value in terms of providing data. The Deloitte (New York, NY, USA) 2014 Survey examined US physicians’ current use and overall views of mobile health (mHealth)... Read more

Hospital News

view channel
Image: Artist rendering of the new Memorial Hermann Cypress medical campus (Photo courtesy Memorial Hermann Health System).

Memorial Hermann to Construct State-of-the-Art Hospital

Memorial Hermann Health System (Houston, TX, USA) is planning to construct a new medical campus in Cypress (TX, USA), with an investment of approximately USD 168 million. The new campus is being built... Read more

Business

view channel

Growth Expected for Global Patient Monitoring Market

The global advanced patient monitoring market has benefited from demand at health facilities and in the home treatment markets. These are the latest findings of Kalorama Information (New York, NY, USA), an independent medical market research firm. The global advanced patient monitoring market includes equipment and devices... Read more
 
Copyright © 2000-2014 Globetech Media. All rights reserved.