Apnea in a child after oral codeine: a genetic variant – an ultra-rapid metabolizer

  1. POLINA VORONOV,
  2. HENRY J PRZYBYLO,
  3. NARASIMHAN JAGANNATHAN

Article first published online: 10 JUN 2007

DOI: 10.1111/j.1460-9592.2006.02182.x

Issue

Pediatric Anesthesia

Pediatric Anesthesia

Volume 17, Issue 7, pages 684–687, July 2007

Additional Information

How to Cite

VORONOV, P., PRZYBYLO, H. J. and JAGANNATHAN, N. (2007), Apnea in a child after oral codeine: a genetic variant – an ultra-rapid metabolizer. Pediatric Anesthesia, 17: 684–687. doi: 10.1111/j.1460-9592.2006.02182.x

Author Information

  1. Department of Anesthesiology, Children's Memorial Hospital, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA

*Voronov Polina, Department of Pediatric Anesthesiology, Children's Memorial Hospital, 2300 Children's Plaza, Chicago, IL, USA (email: pvoronov@childrensmemorial.org).

Publication History

  1. Issue published online: 10 JUN 2007
  2. Article first published online: 10 JUN 2007
  3. Accepted 6 November 2006

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Keywords:

  • codeine;
  • complications;
  • apnea;
  • genetic polymorphism;
  • pediatrics;
  • obstructive sleep apnea

Summary

We present a case of a 29 months old previously healthy child who experienced apnea resulting in brain injury following a dose of acetaminophen and codeine 2 days after an uneventful anesthetic for tonsillectomy. A genetic polymorphism leading to ultra-rapid metabolism of codeine into morphine resulted in narcosis and apnea. This paper discusses the use of codeine for pain relief, obstructive sleep apnea, the alteration of the CYP2D6 gene and the resulting effect on drug metabolism.

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