Suppr超能文献

哺乳期使用可待因的安全性:一位服用可待因的母亲所哺乳的新生儿发生致命性吗啡中毒

Safety of codeine during breastfeeding: fatal morphine poisoning in the breastfed neonate of a mother prescribed codeine.

作者信息

Madadi Parvaz, Koren Gideon, Cairns James, Chitayat David, Gaedigk Andrea, Leeder J Steven, Teitelbaum Ronni, Karaskov Tatyana, Aleksa Katarina

出版信息

Can Fam Physician. 2007 Jan;53(1):33-5.

Abstract

QUESTION

Recently a newborn died from morphine poisoning when his mother used codeine while breastfeeding. Many patients receive codeine for postlabour pain. Is it safe to prescribe codeine for nursing mothers?

ANSWER

When a mother is an ultrarapid metabolizer of cytochrome P450 2D6, she produces much more morphine when taking codeine than most people do. In this situation, newborns might be exposed to toxic levels of morphine when breastfeeding. Options to reduce this risk include discontinuing codeine after 2 to 3 days of use and being aware of symptoms of potential opioid toxicity in both mothers and newborns.

摘要

问题

最近有一名新生儿因母亲在母乳喂养期间使用可待因而死于吗啡中毒。许多患者在产后疼痛时会使用可待因。给哺乳期母亲开可待因是否安全?

答案

当母亲是细胞色素P450 2D6的超快代谢者时,她服用可待因时产生的吗啡比大多数人多得多。在这种情况下,新生儿在母乳喂养时可能会接触到有毒剂量的吗啡。降低这种风险的选择包括在使用2至3天后停用可待因,并留意母亲和新生儿潜在阿片类药物毒性的症状。

相似文献

3
Pharmacogenetics of neonatal opioid toxicity following maternal use of codeine during breastfeeding: a case-control study.
Clin Pharmacol Ther. 2009 Jan;85(1):31-5. doi: 10.1038/clpt.2008.157. Epub 2008 Aug 20.
4
Impact of morphine, fentanyl, oxycodone or codeine on patient consciousness, appetite and thirst when used to treat cancer pain.
Cochrane Database Syst Rev. 2014 May 29;2014(5):CD011056. doi: 10.1002/14651858.CD011056.pub2.
5
Risk to the breast-fed neonate from codeine treatment to the mother: a quantitative mechanistic modeling study.
Clin Pharmacol Ther. 2009 Dec;86(6):634-43. doi: 10.1038/clpt.2009.151. Epub 2009 Aug 26.
6
Codeine, alone and with paracetamol (acetaminophen), for cancer pain.
Cochrane Database Syst Rev. 2014 Sep 19;2014(9):CD006601. doi: 10.1002/14651858.CD006601.pub4.
8
Establishing causality of CNS depression in breastfed infants following maternal codeine use.
Paediatr Drugs. 2008;10(6):399-404. doi: 10.2165/0148581-200810060-00007.
9
Safety issues of maternal drug therapy during breastfeeding.
Clin Pharmacol Ther. 2009 Jan;85(1):20-2. doi: 10.1038/clpt.2008.209.
10
The Implausibility of Neonatal Opioid Toxicity from Breastfeeding.
Clin Pharmacol Ther. 2020 Nov;108(5):964-970. doi: 10.1002/cpt.1882. Epub 2020 Jun 25.

引用本文的文献

1
Phenoconversion and phenotyping of hepatic cytochrome P450: Implications in predictive precision medicine and personalized therapy.
Hepatol Forum. 2024 Sep 10;6(3):121-128. doi: 10.14744/hf.2023.2023.0047. eCollection 2025.
2
Potential Consequences of Codeine Use in Lactating Mothers.
Hosp Pharm. 2016 Feb;51(2):107-109. doi: 10.1310/hpj5102-107. Epub 2016 Feb 1.
4
Acute Pain and Development of Opioid Use Disorder: Patient Risk Factors.
Curr Pain Headache Rep. 2023 Sep;27(9):437-444. doi: 10.1007/s11916-023-01127-0. Epub 2023 Jul 1.
6
Breastfeeding and the Pharmacist's Role in Maternal Medication Management: Identifying Barriers and the Need for Continuing Education.
J Pediatr Pharmacol Ther. 2022;27(2):102-108. doi: 10.5863/1551-6776-27.2.108. Epub 2022 Feb 9.
7
Opioid use in pregnancy: An emerging health crisis.
Obstet Med. 2021 Dec;14(4):211-219. doi: 10.1177/1753495X20971163. Epub 2020 Dec 6.
8
Perspectives from the Society for Pediatric Research: pharmacogenetics for pediatricians.
Pediatr Res. 2022 Feb;91(3):529-538. doi: 10.1038/s41390-021-01499-2. Epub 2021 Apr 6.
9
Risks of maternal codeine intake in breast-fed infants: A Joint Statement of Retraction from the and .
Can Pharm J (Ott). 2020 Nov 18;154(1):7-8. doi: 10.1177/1715163520970443. eCollection 2021 Jan-Feb.
10
Functional phenotyping of the CYP2D6 probe drug codeine in the horse.
BMC Vet Res. 2021 Feb 13;17(1):77. doi: 10.1186/s12917-021-02788-y.

本文引用的文献

1
Pharmacogenetics of morphine poisoning in a breastfed neonate of a codeine-prescribed mother.
Lancet. 2006 Aug 19;368(9536):704. doi: 10.1016/S0140-6736(06)69255-6.
2
Codeine intoxication associated with ultrarapid CYP2D6 metabolism.
N Engl J Med. 2004 Dec 30;351(27):2827-31. doi: 10.1056/NEJMoa041888.
4
Postoperative pain in the neonate: age-related differences in morphine requirements and metabolism.
Intensive Care Med. 2003 Nov;29(11):2009-15. doi: 10.1007/s00134-003-1899-4. Epub 2003 Jul 25.
5
A pharmacogenetic study of uridine diphosphate-glucuronosyltransferase 2B7 in patients receiving morphine.
Clin Pharmacol Ther. 2003 Jun;73(6):566-74. doi: 10.1016/S0009-9236(03)00053-5.
6
Unique CYP2D6 activity distribution and genotype-phenotype discordance in black Americans.
Clin Pharmacol Ther. 2002 Jul;72(1):76-89. doi: 10.1067/mcp.2002.125783.
7
Transfer of drugs and other chemicals into human milk.
Pediatrics. 2001 Sep;108(3):776-89. doi: 10.1542/peds.108.3.776.
8
Pharmacogenetics and adverse drug reactions.
Lancet. 2000 Nov 11;356(9242):1667-71. doi: 10.1016/S0140-6736(00)03167-6.
9
Prospective follow-up of adverse reactions in breast-fed infants exposed to maternal medication.
Am J Obstet Gynecol. 1993 May;168(5):1393-9. doi: 10.1016/s0002-9378(11)90771-6.
10
Codeine and the breastfed neonate.
J Hum Lact. 1993 Dec;9(4):237-40. doi: 10.1177/089033449300900423.

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍。

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

文档翻译

学术文献翻译模型,支持多种主流文档格式。

立即体验