Health Care

Doctors Still Prescribing Risky Codeine To Kids After Tonsillectomy

Doctors Still Prescribing Risky Codeine To Kids After Tonsillectomy”

"Codeine in general for children ought to be a zero event".

Codeine, an opioid pain reliever, came under scrutiny due to its adverse effects on children. According to the FDA, it led to serious breathing troubles, including 24 deaths, in children from January 1969 to May 2015. Chua said he does not think it's lack of awareness, because black box warnings are clear.

"The residual codeine prescribing is concerning since this should be a zero event", says lead author Kao-Ping Chua, M.D., Ph.D., a researcher and pediatrician at University of MI C.S. Mott Children's Hospital who conducted the study with colleagues at the University of Chicago and Harvard Medical School. In 2013, the U.S. Food and Drug Administration issued a "black box" warning, advising doctors against prescribing codeine to children to control tonsillectomy pain. According to Chua, who worked at UChicago Medicine while conducting the research, codeine has historically been among the most common drugs used to treat pain in children following these childhood surgeries.

"Five percent may not sound like a huge number, but you have to remember that the tonsillectomy and adenoid removal is the second most common surgery in children", said Chua, assistant professor of pediatrics and communicable diseases at the University of MI and C.S. Mott Children's Hospital. It is converted to morphine by a liver enzyme, and the speed of this conversion varies from person to person.

"Approximately 1-2% of people are "ultra-metabolizers" who convert codeine to morphine extremely quickly, causing a rapid spike in blood morphine levels and a resulting risk of overdose", he added. As a result, the FDA initiated a safety investigation in August 2012 and ultimately issued a "black box warning" that specifically prohibited the use of codeine for children undergoing these surgeries.

"This is an unacceptable gamble given that there are better alternatives", he added.

The researchers analyzed prescription data from Truven MarketScan Commercial Claims and Encounters database for over 360,000 privately insured children from all across the US who had tonsillectomies, adenoidectomies, or both.

More news: Thomaspartners, Inc. Modifies Its Ownership in Abbott Laboratories (ABT) Stock Last Quarter

Codeine prescribing to children has declined further since 2015, says Dr. Kris Jatana, an otolaryngologist at Nationwide Children's Hospital who was not involved in the Pediatrics study.

The study was conducted to find out who well the doctors in the USA were heeding the warning issued by the FDA.

"There has been a shift away from the codeine prescriptions because of the black box warning". However, Chua said these drugs also have side effects and are prone to abuse, so the best strategy to manage post-surgical pain in children is to start with over-the-counter painkillers and only rely on opioids when absolutely necessary.

"The default position should be, 'let's avoid opioids, ' " Chua said.

"The problem is we don't how each patient metabolizes codeine. Plus, there are alternatives - like Tylenol [acetaminophen] and ibuprofen". "We shouldn't be using codeine for any reason in children".

It's not clear why some doctors continued to prescribe the drug. This trend deserves further study, Chua notes. "Over- the-counter agents like that actually have been proven to be quite effective in managing pain after tonsillectomies and adenoidectomies", he says.



Like this

loading...
loading...

Latest


16 November 2017
Facebook adds 'trust indicators' to news articles to offer publisher info
To achieve its goal, Facebook is working with the Trust Project , "an worldwide consortium of news and digital companies". Facebook has taken several concrete steps to prevent the flow of fake news on the world's largest social network.

16 November 2017
The Navient Corporation (NAVI) Position Increased by the Bank of West
The Livforsakringsbolaget Skandia Omsesidigt holds 23,909 shares with $2.09 million value, up from 14,109 last quarter. The firm has "Equal-Weight" rating by Barclays Capital given on Friday, August 25. 613 are held by Evercore Wealth Llc.

16 November 2017
Joe Schmidt Names Exciting Side To Take On Fiji On Saturday
Darren Sweetnam makes his starting debut on the wing while Joey Carbery has been named at number ten, with Kieran Marmion at nine. Live coverage of Ireland v Fiji begins on Saturday on RTÉ 2 television and RTÉ Player at 4.30.

16 November 2017
Gilead Sciences, Inc. (GILD) - Analyst rating score stands at 2.40
Peddock Capital Advsr Ltd Company stated it has 16,674 shares. 5,350 are held by West Coast Financial Limited Liability Corp. On Thursday, June 1 MARTIN JOHN C sold $4.78M worth of Gilead Sciences, Inc . (NASDAQ: GILD ) rating on Tuesday, November 8.

16 November 2017
United Kingdom inflation steady at five-year high in October
Despite a cut in taxes, retail petrol prices have gone up by 7.6 percent and diesel by 6.6 percent in New Delhi in the past year . Earlier this month, the central bank raised its main interest rate by a quarter percentage point to 0.5 percent.

16 November 2017
Cuyahoga Falls man accused of threatening 'historic' mass shooting
A gunman opened fire on a crowd of concertgoers in Las Vegas on October 1, killing 59 people and injuring hundreds more. The FBI says Li acknowledged sending the texts to his wife but didn't intend to carry out the shootings.

16 November 2017
AmEx partners Ripple and Santander for blockchain-enabled cross-border payments
Moreover, Ripple's payments network has the "capability to allow American Express to connect with customers across the globe". The Ripple price (XRP/USD) has surged in today's trading.

16 November 2017
Armenia can become bridge between European Union and Russia - Dutch parliament speaker
Still, the top Russian diplomat said that worldwide issues will also be discussed during the meetings. Putin noted that cultural and humanitarian ties are developing no less actively.

16 November 2017
Vetr Inc. Lowers Lockheed Martin Corporation (LMT) to Buy
It is positive, as 37 investors sold LMT shares while 393 reduced holdings. 123 funds opened positions while 504 raised stakes. Equity analyst Bank of America Corporation released a research note on LMT with a rating of "Buy" and price target of $360.00.

16 November 2017
Stock within Investors Radar: NetApp, Inc. (NTAP)
The company has a market cap of $12,306.34, a PE ratio of 19.17, a price-to-earnings-growth ratio of 1.60 and a beta of 1.16. Cash from operations amounted to $315 million, almost doubling the second quarter of fiscal 2017's results of $158 million.