OBJECTIVE Paracetamol /codeine has shown a strong analgesic activity in several studies conducted among different kind of subjects, including those with trauma. Nevertheless, its efficacy in patients accessing the Emergency Department (ED) for different kind of pain has never been tested. PATIENTS AND METHODS This is a cross-sectional, observational, prospective, cohort study. Inclusion crite...

A method is described for the determination of codeine and its metabolite, morphine, at low nanogram concentrations in plasma. Analysis is accomplished by high-performance liquid chromatography utilizing a cyanopropyl normal bonded phase (NBP) column in reversed-phase mode and two electrochemical detectors in series configuration. Two internal standards are utilized, ethyl morphine for codeine ...

Prieto-Lastra et al described three patients who developed adverse reactions after receiving codeine. It is known that codeine can induce direct mast cell degranulation and therefore non-IgE mediated reactions. Nonsteroidal anti-inflammatory drugs (NSAIDs) are frequent cause of urticaria and patients with chronic urticaria can present worsening of symptoms with their use. One alternative for th...

After postoperative deaths in children who were prescribed codeine, several pediatric hospitals have removed it from their formularies. These deaths were attributed to atypical cytochrome P450 2D6 (CYP2D6) pharmacogenetics, which is also implicated in poor analgesic response. Because codeine is often prescribed to patients with sickle cell disease and is now the only Schedule III opioid analges...

A clinical study was designed to determine if there was a predictable relationship between saliva and plasma codeine concentrations. Drug-free volunteers (n = 17) were administered a 30-mg dose of liquid codeine phosphate. Plasma and saliva specimens were collected at various times for 24 h after administration. Plasma and saliva were analyzed for codeine and morphine by positive-ion chemical i...

Human use of pharmaceuticals results in the excretion and disposal of compounds that become part of municipal and domestic waste streams. On-site waste water disposal and leaking city sewer systems can provide avenues for the migration of effluent to the underlying aquifers. This research assessed the occurrence and persistence of 22 target pharmaceuticals in septic tank effluent and two shallo...

There is very limited knowledge about possible pharmacokinetic interactions between opioid analgesics and nonsteroidal antiinflammatory drugs (NSAIDs), which are commonly used in combination for the treatment of chronic pain. The major metabolic pathway of the weak opioid codeine is glucuronidation to codeine6-glucuronide. Therefore we investigated the influence of the NSAID diclofenac on the f...

An analytical method is presented here for the assessment of morphine and codeine concentrations in human serum by employing mass spectrometry in the selective ion monitoring mode following its separation with gas chromatography. Deuterated (marked with heavy water) analogies of the analytes were used as surrogate internal standards. Samples were cleaned up using solid phase extraction. The tar...

Opium poppy (Papaver somniferum) produces medicinally important benzylisoquinoline alkaloids, including the analgesics codeine and morphine, in the morphinan pathway. We aligned three dioxygenases that were recently discovered in P. somniferum and subsequently identified the nonconserved regions. Two of these enzymes, codeine O-demethylase (PsCODM) and thebaine O-demethylase (PsT6ODM), are know...