Related Experiment Video

Updated: May 7, 2026

CO2-Lasertonsillotomy Under Local Anesthesia in Adults
05:07

CO2-Lasertonsillotomy Under Local Anesthesia in Adults

Published on: November 6, 2019

29.3K

Codeine-related adverse drug reactions in children following tonsillectomy: a prospective study

Cynthia A Prows1, Xue Zhang, Myra M Huth

  • 1Division of Human Genetics, University of Cincinnati, Cincinnati, Ohio; Division of Pharmacy, University of Cincinnati, Cincinnati, Ohio.

The Laryngoscope
|October 15, 2013
PubMed

Insights

Codeine use after tonsillectomy in children is linked to adverse drug reactions (ADRs), with factors like genetics and postoperative day influencing risk. These findings support avoiding routine codeine prescriptions for pediatric tonsillectomy patients.

Area of Science:

  • Pharmacogenomics
  • Pediatric Surgery
  • Adverse Drug Reactions

Background:

  • Codeine is commonly prescribed for pain management after pediatric tonsillectomy.
  • Understanding factors contributing to codeine's adverse drug reactions (ADRs) in children is crucial for safe prescribing.
  • Previous studies have not comprehensively evaluated ADRs in a homogenous pediatric population undergoing tonsillectomy.

Purpose of the Study:

  • To prospectively identify factors associated with codeine-related ADRs in children after outpatient tonsillectomy.
  • To analyze the incidence and types of ADRs based on race and postoperative day.
  • To investigate predictors of ADR risk and sedation in a subcohort of white children.

Main Methods:

  • A prospective, genotype-blinded observational study enrolled 249 children aged 6-15 undergoing tonsillectomy.
  • Parents meticulously documented daily codeine-related ADRs and sedation scores for postoperative days 0-3.
  • Statistical analysis identified factors associated with ADR risk and sedation in a subcohort of white children.

Main Results:

  • Of 134 children who received codeine, 79% reported at least one ADR.
  • Nausea was the most common ADR across racial groups.
  • In white children, ADR risk correlated with CYP2D6 genotype, postoperative day, and sex.

Conclusions:

  • Multiple factors, including genetic variations (CYP2D6), postoperative day, and sex, are associated with codeine-related ADRs in children.
  • Increased pain and early postoperative days (0-1) were linked to higher sedation risk.
  • The findings support the FDA's recommendation against routine codeine use in children post-tonsillectomy.
Abstract

Keywords:
Pharmacogeneticsadverse drug reactionsadverse eventspharmacogenomics

More Related Videos

Isolation of Tonsillar Mononuclear Cells to Study Ex Vivo Innate Immune Responses in a Human Mucosal Lymphoid Tissue07:38

Isolation of Tonsillar Mononuclear Cells to Study Ex Vivo Innate Immune Responses in a Human Mucosal Lymphoid Tissue

Published on: June 14, 2020

6.9K

Related Concept Videos

Tonsillitis II: Management01:26

Tonsillitis II: Management

This lesson will focus on the different treatment options for managing tonsillitis, which typically depend on the cause and severity.
695
Tonsillitis I: Introduction01:30

Tonsillitis I: Introduction

Tonsillitis is inflammation of the tonsils, which are two lymphoid tissue masses at the back of the throat. This condition can cause discomfort and irritation in the throat.
Etiology
Three primary contributing factors have been identified.
4.0K
Chronic Pharyngitis01:23

Chronic Pharyngitis

Chronic pharyngitis refers to persistent inflammation of the pharyngial mucosa.
Etiology
It often arises from persistent viral or bacterial infections affecting sinuses and tonsils.
Additional contributing factors include inadequate dental hygiene, mouth breathing, recurring tonsillitis, allergic rhinitis, laryngopharyngeal reflux, and exposure to smoke, chemicals, and other environmental pollutants. Allergic reactions to pollen, mold, and pet dander, chronic cough, excessive voice usage,...
16.9K
Local Anesthetics: Adverse Effects01:12

Local Anesthetics: Adverse Effects

While local anesthetics are generally safe and well-tolerated, they can occasionally cause adverse effects that vary in severity. Local anesthetics can induce toxicity at two distinct levels. They can either produce local effects through direct contact with the neural elements or be absorbed into the bloodstream from the injection site, leading to systemic effects.
Once absorbed into the systemic circulation, local anesthetics can affect the organs that depend on the functioning of sodium...
1.0K
Upper Respiratory Drugs: Antitussives, Expectorants, and Mucolytics01:23

Upper Respiratory Drugs: Antitussives, Expectorants, and Mucolytics

Respiratory symptoms, such as congestion and cough, commonly accompany respiratory tract conditions. Various medications, such as antitussives, expectorants, and mucolytics, play crucial roles in providing relief.
Antitussives include codeine, dextromethorphan (Robitussin), and benzonatate (Tessalon). Codeine and dextromethorphan exert their effects centrally by suppressing the cough reflex center in the medulla.  Benzonatate operates peripherally within the respiratory tract by...
1.8K
Endoscopic Studies II: Thoracocentesis01:26

Endoscopic Studies II: Thoracocentesis

Thoracentesis(Thoracocentesis), commonly known as pleural tap, is a medical procedure where a 22 gauge needle is inserted into the pleural space, the area between the lung and chest wall. This procedure is commonly performed to diagnose or treat various respiratory disorders.
Description
Excess pleural fluid or air may accumulate in some respiratory disorders in the thoracic cavity. To treat pleural effusion, a physician conducts thoracentesis by carefully piercing the chest wall and entering...
2.5K