Recently, an advisory committee to the FDA has recommended codeine be contraindicated for pain and cough management in children and adolescents due to concerns for respiratory depression and death. This FDA warning was also extended to prescriptions of codeine to nursing mothers.
In Europe, codeine is contraindicated in children under age 12 for cold or cough, and the European Medicines Agency recommends against using the drug in those age 12 to 18 years-of-age who have breathing difficulties.
This article explores the foundation for the necessity of this recommendation.
Understanding the metabolism of codeine is important for the clinican and forensic pathologist
When a specific allergen gains acess to the circulation, the allergen can react with basophils of the blood and mast cells in the tissues located immediately outside the small blood vessels, if the basophils and masts cells have been sensitized by the attachment of IgE reagins. This can be followed by a widespread allergic reaction throughout the vascular system and closely associated tissues, referred to as anaphylaxis, which can lead to forensic consequences.
Continue reading Improving Laboratory Testing for Anaphylaxis for Immediate Pragmatic Benefits