Feb. 20, 2013 -- The FDA is again warning of the risk for fatal and life-threatening side effects from codeine in young children who take the drug for pain relief after having their tonsils or adenoids removed for obstructive sleep apnea.
The FDA cites reports of three children who died and one who developed life-threatening breathing problems. The agency had previously highlighted these cases and now says it is conducting a review to see whether other cases occurred in children who took codeine after other types of surgery.
The four children were 2 to 5 years old, and all had evidence of a genetic variation of a liver enzyme.
This enzyme converts codeine into morphine, but the genetic variation carried by these children speeds up that process. That causes higher-than-normal levels of morphine in the blood after taking codeine.
High levels of morphine may result in breathing problems, which can be fatal, according to the FDA.
All of the children received codeine doses that were within the typical dose range, but they started to develop signs of trouble within one to two days. In the children who died, morphine concentrations were higher than what is typical, the FDA notes.
Parents and caregivers who notice unusual sleepiness, confusion, or difficult or noisy breathing in a child who has taken codeine should call 911 immediately, as these are signs of overdose.
The FDA is asking health care professionals to be aware of the risk of giving codeine to children, particularly in those who have had surgery to remove their tonsils or adenoids for obstructive sleep apnea. Doctors who prescribe the codeine should use the lowest effective dose for the shortest period of time on an as-needed basis. The drugs should not be used around the clock.
The genetic variation that leads to this reaction is estimated to happen in one to seven people per 100, but the incidence can be much higher in certain ethnic groups, the FDA cautions. For instance, among African/Ethiopian populations, nearly 1 in 3 may have this inherited condition.
The FDA notes that tests can tell if a person has this genetic variation.
*this article is taken from webMD. here shows the clearer reason why children below 2 years old should never been prescribed anti-cough medication ( most of anti-cough medications contain codeine)
so how to treat the upper respiratory tract infection (URTI) in children below 2 years old?
i always encountered a lot of URTI cases among children in clinic.most of the parents were expecting me to give anti-cough medication for their children, which i never give anyway.
why?
-the strongest reason is ABOVE.
-2nd, most of the URTI is caused by viral infection, which will resolved as the children's body defense (immunity) will combat those viruses naturally. this will take up to 1 week for the symptoms to completely disappear.
why no antibiotic?
antibiotic is indicated only when there is source of BACTERIAL infection. not VIRUSES! yes when parents go to private clinic, they will prescribed your children antibiotic, mostly not because your children need it, but for their own financial benefit!
why the symptoms still not subsided after 1 week?
-1st, maybe there is secondary bacterial infection on top of viruses itself, this usually need to be proven by auscultation, chest X-Ray or blood investigation (Full Blood Count).
-2nd, maybe your children had another viral infection.REMEMBER there are thousands of viruses surrounding us. your children will not get similar viral infection as they are already immuned to it, but they will definitely potential of having other viral infections!
so parents, help your children to boost up their immunity by giving them a good healthy food and drinks! as for the children below 2 years old, the best food of all is definitely BREAST MILK!!! please mothers, do not give up giving the BEST for your children!
yes you may top up your children's diet with vitamins if necessary. among the vitamins suggestable for your children that available from SHAKLEE products are;
any inquiry, please do not hesitate to call/sms/whatsapp/email me @ :
017-9069616
amycheali85@gmail.com
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