Prolonged central apnoea after intravenous morphine administration in a 12-year-old male with a UGT1A1 loss-of-function polymorphism.

ABSTRACT:

Adverse event

Repeated and prolonged episodes of central apnoea and hypoxia after receiving intravenous morphine for analgesia and ketamine for sedation.

Drug implicated

Intravenous morphine sulfate.

The patient

Previously healthy 12-year-old male with no history of sleep apnoea who presented with distal tibia and fibula fracture.

Evidence that links drug to event

Pharmacogenomic testing revealed that the patient was homozygous for the T allele at the rs887829 SNP in UGT1A1, an enzyme involved in the metabolism of morphine. This polymorphism is a loss-of-function variant, leading to impaired metabolism of morphine.

Mechanism

Morphine is metabolized by UDP-glucuronosyltransferase (UGT)-2B7 and UGT1A1 to form its major metabolites morphine-3-glucuronide (M

SUBMITTER: Toce MS 

PROVIDER: S-EPMC6303239 | biostudies-literature | 2019 Jan

REPOSITORIES: biostudies-literature