What is the potential consequence of a patient having extremely functional CYP2D6 enzymes on the drug codeine?
Understand the Problem
The question is asking about how the genetic variability in CYP2D6 enzyme functionality can affect the metabolism of codeine, specifically whether this leads to an increased or decreased therapeutic effect or risk of toxicity. It seeks to understand the pharmacogenomic implications of CYP2D6 enzymatic activity on codeine's efficacy and safety.
Answer
Life-threatening opioid intoxication due to rapid conversion to morphine.
Patients with extremely functional CYP2D6 enzymes can experience life-threatening opioid intoxication due to rapid conversion of codeine to morphine, resulting in high plasma morphine concentrations.
Answer for screen readers
Patients with extremely functional CYP2D6 enzymes can experience life-threatening opioid intoxication due to rapid conversion of codeine to morphine, resulting in high plasma morphine concentrations.
More Information
Codeine is a prodrug that is metabolized into morphine primarily by the enzyme CYP2D6. People who are ultrarapid metabolizers have multiple copies of the CYP2D6 gene, which leads to excessive morphine levels after standard doses of codeine, raising the risk of toxicity.
Tips
A common mistake is assuming faster metabolism always leads to effective treatment. In this case, it can cause dangerous overdose.
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