Codeine intoxication associated with ultrarapid CYP2D6 metabolism
Codeine intoxication associated with ultrarapid CYP2D6 metabolism
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DOI：
10.1056/nejmoa041888
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发表时间：
2004-12-30
影响因子：
158.5
通讯作者：
Desmeules, J
中科院分区：
文献类型：
--
作者：
Gasche, Y;Daali, Y;Desmeules, J
一名患者在接受小剂量可待因治疗与双侧肺炎相关的咳嗽后发生危及生命的阿片类药物中毒。可待因被CYP2D6生物活化为吗啡，然后进一步进行葡萄糖醛酸化。CYP2D6基因分型显示患者有三个或更多的功能等位基因，这一发现与可待因的超快速代谢一致。我们将毒性归因于这种基因型，以及其他药物对CYP3A4活性的抑制和肾功能的一过性降低。
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.