O Reilly David, Thomas Mathew, Moylett Edina
School of Medicine, National University of Ireland, Galway, HSE West, Galway, Connacht, Ireland Donegal Clinical Research Academy, Letterkenny General Hospital, HSE West, Letterkenny, Ulster, Ireland.
Department of Paediatrics, Letterkenny General Hospital, HSE West, Letterkenny, Ulster, Ireland.
BMJ Case Rep. 2015 Dec 23;2015:bcr2015212727. doi: 10.1136/bcr-2015-212727.
Codeine is widely prescribed in clinical practice with over the counter (OTC) preparations of codeine freely available for consumption typically as a component of remedies for the common cold/cough. We describe the first reported case of acute confusional state in a previously healthy 14-year-old girl ultimately attributed to inappropriate codeine use. The usage of codeine in the paediatric setting has been highlighted in recent years with many reported deaths--mostly due to respiratory depression. The risks associated with codeine usage may be particularly unnecessary with OTC cough suppressants as evidence of efficacy is absent. Finally, codeine dependence is a common problem among adults and has been reported locally and internationally among adolescents. The combination of lack of efficacy, risk of acute intoxication and dependence, suggests that the use of OTC codeine preparations may be unwarranted.
可待因在临床实践中被广泛开具处方，非处方（OTC）可待因制剂通常作为普通感冒/咳嗽药物的成分可随意获取以供消费。我们描述了首例报告的急性意识模糊状态病例，患者为一名先前健康的14岁女孩，最终归因于不当使用可待因。近年来，可待因在儿科环境中的使用受到关注，有许多死亡报告——主要是由于呼吸抑制。由于缺乏疗效证据，使用OTC止咳药时与可待因使用相关的风险可能尤其不必要。最后，可待因依赖在成年人中是一个常见问题，在本地和国际上的青少年中也有报告。缺乏疗效、急性中毒风险和依赖性表明，使用OTC可待因制剂可能是不必要的。
