Sun14November0130PM 6

Are the following true regarding codeine for postoperative analgesia?

True / False

Is contraindicated in CYP2D6 rapid metabolisers Correct

Has a recommended maximum daily dose of 120 mg in children age 12-18 years Incorrect answer selected

Is recommended after tonsillectomy for obstructive sleep apnoea in children over the age of 5 years Correct

Should be avoided in children under 12 years Correct

Is recommended for breastfeeding mothers Correct

Explanation

Codeine is a prodrug converted to morphine in the liver by CYP2D6 enzyme. Known CYP2D6 rapid metabolisers are at risk of toxic blood levels of morphine.

A recent European review of morphine toxicity in children receiving codeine for pain after surgery has resulted in new recommendations that codeine should be avoided for acute analgesia in all children under 12 years (thus also in breastfeeding mothers as morphine passes into breast milk) and avoided if possible in older children. Moreover, it is contraindicated in all children under 18 years of age for adenotonsillectomy in the treatment of obstructive sleep apnoea.

The maximum daily dose in children 12-18 years is 240 mg.

Reference:

European Medicines Agency. Review of Codeine-containing medicines.

Medicines and Healthcare Products Regulatory Agency (MHRA). Codeine: restricted use as analgesic in children and adolescents after European safety review.

Tremlett MR. Wither codeine? Paediatr Anaesth. 2013;23:677-83.

Answer Statistics

Not enough data to display the statistics

Average score: 77.32%

Times answered: 246