Rachel
10-18-2010, 09:07 PM
Heal or Harm? The Truth About Prescription Drugs
Prescription drugs meant to make your child feel better may be putting her at risk. Now Canadian researchers are figuring out why — and their work is saving kids' lives
A parent’s worst nightmare can happen as easily as this. Your toddler is cranky after having surgery to remove his tonsils and adenoids. You measure out and give him a dose of the codeine syrup prescribed by his doctor — repeating it every four to six hours, exactly as you were told to do. On the second night following the surgery, your son develops a fever and wheezing, then sleeps. When you walk into his bedroom the next morning, his face looks pale and he isn’t breathing. You call 911. The paramedics can’t revive him.
That is how a two-year-old Ontario boy died, suffering a fatal reaction to codeine after his tonsils and adenoids were removed to treat sleep apnea. An autopsy showed the child had toxic levels of morphine in his blood. His mother had given him only the prescribed dose of codeine and acetaminophen syrup following a routine operation.
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Why did it happen? In a 2009 report in The New England Journal of Medicine, Canadian drug surveillance researchers revealed that the toddler had extra copies of a gene that converts codeine into morphine, which can slow or stop breathing. He was an ultra-rapid metabolizer, who converted codeine into morphine much faster than most children.
Unfortunately, it’s not just the drugs prescribed to children that can harm them. Like almost half of the new mothers in Canada, Rani Jamieson, a Toronto accountant, was prescribed Tylenol No. 3 (with codeine) after giving birth to her son, Tariq. Twelve days later, he died of a morphine overdose. An investigation found that the mother’s breastmilk had a concentration of morphine 10 to 20 times greater than expected and the baby’s blood had lethal levels. In a 2006 report, the drug surveillance researchers discovered that the mom was an ultra-rapid metabolizer, whose genes turned her breastmilk into a toxic brew.
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These two deaths, triggered by unexpected adverse drug reactions (ADRs) to a popular pain reliever, are not isolated examples. They represent a more widespread problem that should concern all parents. More than 2,500 Canadian kids die from toxic reactions to drugs each year and many more develop permanent disabilities, such as heart damage and loss of hearing. One of seven children treated in hospital suffers an ADR. “Young kids are particularly vulnerable because they can’t evaluate or express their response to a medication,” says Bruce Carleton, a clinical pharmacologist at BC Children’s Hospital in Vancouver and co-leader of a Canada-wide paediatric ADR surveillance network.
Also, says Carleton, “over 75 percent of drugs used to treat children have never been tested for safety in kids.” He set up the network with University of British Columbia geneticist Michael Hayden to track and investigate ADRs in kids. They saw a unique opportunity to save lives and prevent disabling side effects by identifying genetic differences that predispose kids to ADRs.
The network, known as the Canadian Pharma-cogenomic Network for Drug Safety (CPNDS), operates in 13 children’s hospitals from coast to coast. Carleton estimates that half of ADRs in children result from differences in genetic makeup that cause some children to break down certain drugs differently. Some other examples are: life-threatening skin reactions to ibuprofen; anaphylactic reactions to antibiotics; and destruction of bone tissue from corticosteroids.
“If we know in advance that some children have specific genetic variations that lead to harmful reactions, we can make better decisions about using a particular drug,” says Carleton, a senior clinician at Vancouver’s Child & Family Research Institute.
Prescription drugs meant to make your child feel better may be putting her at risk. Now Canadian researchers are figuring out why — and their work is saving kids' lives
A parent’s worst nightmare can happen as easily as this. Your toddler is cranky after having surgery to remove his tonsils and adenoids. You measure out and give him a dose of the codeine syrup prescribed by his doctor — repeating it every four to six hours, exactly as you were told to do. On the second night following the surgery, your son develops a fever and wheezing, then sleeps. When you walk into his bedroom the next morning, his face looks pale and he isn’t breathing. You call 911. The paramedics can’t revive him.
That is how a two-year-old Ontario boy died, suffering a fatal reaction to codeine after his tonsils and adenoids were removed to treat sleep apnea. An autopsy showed the child had toxic levels of morphine in his blood. His mother had given him only the prescribed dose of codeine and acetaminophen syrup following a routine operation.
Also see:
Doctor's office etiquette: 10 tips for a smooth visit
Embrace the Chaos: Finding a new family doctor isn't easy
What's new with flu this year?
Why did it happen? In a 2009 report in The New England Journal of Medicine, Canadian drug surveillance researchers revealed that the toddler had extra copies of a gene that converts codeine into morphine, which can slow or stop breathing. He was an ultra-rapid metabolizer, who converted codeine into morphine much faster than most children.
Unfortunately, it’s not just the drugs prescribed to children that can harm them. Like almost half of the new mothers in Canada, Rani Jamieson, a Toronto accountant, was prescribed Tylenol No. 3 (with codeine) after giving birth to her son, Tariq. Twelve days later, he died of a morphine overdose. An investigation found that the mother’s breastmilk had a concentration of morphine 10 to 20 times greater than expected and the baby’s blood had lethal levels. In a 2006 report, the drug surveillance researchers discovered that the mom was an ultra-rapid metabolizer, whose genes turned her breastmilk into a toxic brew.
More Stories from Today's Parent
Children's Health Guide
Med Alert!
First-Aid Guide
7 Super Foods
These two deaths, triggered by unexpected adverse drug reactions (ADRs) to a popular pain reliever, are not isolated examples. They represent a more widespread problem that should concern all parents. More than 2,500 Canadian kids die from toxic reactions to drugs each year and many more develop permanent disabilities, such as heart damage and loss of hearing. One of seven children treated in hospital suffers an ADR. “Young kids are particularly vulnerable because they can’t evaluate or express their response to a medication,” says Bruce Carleton, a clinical pharmacologist at BC Children’s Hospital in Vancouver and co-leader of a Canada-wide paediatric ADR surveillance network.
Also, says Carleton, “over 75 percent of drugs used to treat children have never been tested for safety in kids.” He set up the network with University of British Columbia geneticist Michael Hayden to track and investigate ADRs in kids. They saw a unique opportunity to save lives and prevent disabling side effects by identifying genetic differences that predispose kids to ADRs.
The network, known as the Canadian Pharma-cogenomic Network for Drug Safety (CPNDS), operates in 13 children’s hospitals from coast to coast. Carleton estimates that half of ADRs in children result from differences in genetic makeup that cause some children to break down certain drugs differently. Some other examples are: life-threatening skin reactions to ibuprofen; anaphylactic reactions to antibiotics; and destruction of bone tissue from corticosteroids.
“If we know in advance that some children have specific genetic variations that lead to harmful reactions, we can make better decisions about using a particular drug,” says Carleton, a senior clinician at Vancouver’s Child & Family Research Institute.