期刊
ANESTHESIA AND ANALGESIA
卷 107, 期 3, 页码 926-929出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1213/ane.0b013e31817b796e
关键词
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资金
- R. Sackler Research Foundation
We observed opioid-related respiratory depression in a patient receiving tramadol via patient-con trolled analgesia. Predisposing factors were the patients genetic background and renal impairment. Complete recovery occurred after naloxone administration, thus confirming opioid intoxication. Analysis of the patient's genotype revealed a CYP2D6 gene duplication resulting in ultra-rapid metabolism of tramadol to its active metabolite (+)O-desmethyltramadol. Concomitant renal impairment resulting in decreased metabolite clearance enhanced opioid toxicity. This genetic CYP2D6 variant is particularly common in specific ethnic populations and should be a future diagnostic target whenever administration of tramadol or codeine is anticipated, as both drugs are subject to a comparable CYP2D6-dependent metabolism.
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