可待因和曲马多用于儿科人群——现在的结论是什么？

The Use of Codeine and Tramadol in the Pediatric Population-What is the Verdict Now?

出版信息

J Pediatr Health Care. 2019 Jan;33(1):117-123. doi: 10.1016/j.pedhc.2018.04.016.

DOI:10.1016/j.pedhc.2018.04.016

Abstract

Codeine and tramadol are opioid analgesics approved for the management of pain in the United States. Both agents are metabolized in the liver to active compounds via the cytochrome P450 2D6 enzyme. Case reports of pediatric patients with overactive CYP2D6 enzymes have been reported. These ultra-rapid metabolizers experience an increase in the production of active metabolites of codeine and tramadol, which can lead to oversedation, respiratory depression, and death. In 2017, the U.S. Food and Drug Administration updated their warnings regarding codeine and tramadol use in the pediatric population, making their use contraindicated in patients under the age of 12 years.

摘要

可待因和曲马多是在美国批准用于治疗疼痛的阿片类镇痛药。这两种药物都通过细胞色素 P450 2D6 酶在肝脏中代谢为活性化合物。已经报道了患有超活性 CYP2D6 酶的儿科患者的病例报告。这些超快代谢者经历可待因和曲马多的活性代谢物产生增加，这可能导致过度镇静、呼吸抑制和死亡。2017 年，美国食品和药物管理局更新了他们关于可待因和曲马多在儿科人群中使用的警告，规定 12 岁以下患者禁用。