期刊
NEW ENGLAND JOURNAL OF MEDICINE
卷 351, 期 27, 页码 2827-2831出版社
MASSACHUSETTS MEDICAL SOC
DOI: 10.1056/NEJMoa041888
关键词
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Life-threatening opioid intoxication developed in a patient after he was given small doses of codeine for the treatment of a cough associated with bilateral pneumonia. Codeine is bioactivated by CYP2D6 into morphine, which then undergoes further glucuronidation. CYP2D6 genotyping showed that the patient had three or more functional alleles, a finding consistent with ultrarapid metabolism of codeine. We attribute the toxicity to this genotype, in combination with inhibition of CYP3A4 activity by other medications and a transient reduction in renal function.
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