Zolezzi M, Al Mohaimeed S A
Department of Pharmaceutical Services, Riyadh Armed Forces Hospital, Kingdom of Saudi Arabia.
Ann Pharmacother. 2001 Oct;35(10):1211-3. doi: 10.1345/aph.10326.
To describe an adverse effect with intravenous codeine in a chid diagnosed with sickle cell anemia.
A seven-year-old boy with sickle cell anemia was admitted to the emergency department with severe pain unresponsive to high doses of oral acetaminophen; subsequently, intravenous codeine phosphate was administered. The patient immediately developed a tonic-clonic seizure, which was treated with intravenous diazepam and naloxone.
Seizures associated with the intravenous administration of codeine phosphate have not been extensively reported in the literature, and special precautions for using the parenteral route for this drug have been vague and limited. Because of the frequent need for acute pain control in children with sicke cell crisis, they may be exposed to this type of reaction when intravenous narcotics are administered. The need for clear guidelines regarding the drug's appropriate parenteral dosing and administration is essential.
Codeine phosphate-induced seizures are not common. The need for special instructions for its intravenous administration may prevent this type of reaction, especially in patients in need of acute pain control requiring intravenous narcotics.
描述静脉注射可待因在一名诊断为镰状细胞贫血患儿身上产生的不良反应。
一名患有镰状细胞贫血的7岁男孩因对大剂量口服对乙酰氨基酚无反应的严重疼痛而被收入急诊科；随后，静脉注射了磷酸可待因。患者立即出现强直阵挛性发作，通过静脉注射地西泮和纳洛酮进行治疗。
静脉注射磷酸可待因相关的癫痫发作在文献中尚未有广泛报道，且关于该药物肠外给药途径的特殊预防措施一直模糊且有限。由于镰状细胞危象患儿经常需要控制急性疼痛，在静脉注射麻醉药时他们可能会面临这种类型的反应。制定关于该药物合适的肠外给药剂量和给药方式的明确指南至关重要。
磷酸可待因诱发的癫痫发作并不常见。对其静脉注射进行特殊说明可能会预防这类反应，尤其是在需要静脉注射麻醉药来控制急性疼痛的患者中。
