• Korean Journal of Clinical Pharmacy
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• v.25 no.4
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• pp.273-279
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• 2015

Objective: Codeine may result in death or respiratory depression in children, particularly who are rapid metabolizer of CYP2D6, therefore it should be used cautiously among children under 12 years of age. This study was to investigate the prescribing pattern of codeine among children according to the age group, prescribed diagnosis, type of medical service and medical specialties. Method: We used Korea Health Insurance Review and Assessment Service-National Patient Sample (HIRA-NPS) database. Study subjects included inpatients or outpatients, who were prescribed codeine between January, 1, 2011 and December, 31, 2011. Contraindicated use of codeine was defined as the use of codeine at least one times under aged 12. Age groups were subclassified according to the <2 years, 2-4 years, 5-8 years, and 9-11 years. Frequently prescribed diagnosis (ICD-10), type of medical service, and medical specialties were also described among codeine users under aged 12. Results: Codeine users were 6,411 inpatients (9,958 prescriptions), and 3,397 outpatients (6,258 prescriptions), respectively. Codeine prescription under 12 years of age were 2.1% (210 prescriptions) among inpatients, and 12.3% (776 prescriptions) among outpatients (p-value<0.05). Outpatient prescriptions of codeine under 12 aged were issued mostly from primary care clinics and frequent diagnosis were unspecified bronchopneumonia (51.6%), and vasomotor rhinitis (23.7%). Conclusion: This study found prescribing of codeine under 12 aged is common in outpatient and primary clinics. Nationwide and community-based efforts should be needed to reduce inappropriate prescribing among children.

• The Korean Journal of Pain
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• v.11 no.1
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• pp.74-80
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• 1998

Background: Myprodol, a newly introduced combination analgesics with codeine, ibuprofen and paracetamol was evaluated in the dental surgery patients for its efficacy and side effects. Methods: Total 60 ASA I or II outpatients dental surgical patients were randomly assigned into three groups(n=20 each). After various oral procedures, one of three oral analgesics, myprodol, ibuprofen or codeine, was prescribed to each patients in double blind fashion for three days. Each patient was followed carefully by daily phone calls for verbal analog pain scale, side effects and patient's satisfaction level. Results: Demographic data and duration of surgery revealed no statistical differences in all three groups. Myprodol group showed better verbal analgesic scores consistently for the study period than ibuprofen or codeine group. Adverse effects were minimal. Patients' satisfaction level was high in all three groups. Conclusion: We conclude that myprodol is an excellent oral analgesic for day-surgery based dental procedure patients. This effect appears to be synergistic among different analgesics rather than additive.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.30 no.2
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• pp.143-149
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• 2004

Background: Some clinical trials have reported that a new analgesic combination of tramadol and acetaminophen provides good efficacy in various pain models. For the more clinical uses of this agent, comparisons about the onset of analgesia and analgesic efficacy in the acute state of pain with the other drugs known as strong analgesics were needed. Purpose: The goal of this study was to compare the times to onset of analgesia and the other analgesic efficacy of 75 mg tramadol/650 mg acetaminophen and 20 mg codeine/500 mg acetaminophen/400 mg ibuprofen in the treatment of acute pain after oral surgery. Patients and Methods: Using a randomized, single-dose, parallel-group, single-center, and active-controlled test design, this clinical study compared the times to onset of analgesia using a two-stopwatch technique and the other analgesic efficacy of the single-dose tramadol/acetaminophen and codeine/acetaminophen/ibuprofen. These were assessed in 128 healthy subjects with pain from oral surgical procedures involving extraction of one or more impacted third molars requiring bone removal. From the time of pain development, the times to onset of perceptible and meaningful pain relief, pain intensity, pain relief, an overall assessment, and adverse events of the study medications were recorded for 6 hours. Results: The demographic distribution and baseline pain data in the two groups were statistically similar. The median times to onset of perceptible pain relief were 21.0 and 24.4 minutes in the tramadol/acetaminophen and codeine/acetaminophen/ibuprofen groups respectively and those to onset of meaningful pain relief were 56.4 and 57.3 minutes, which were statistically similar. The other efficacy variables such as mean total pain relief (TOTPAR) and the sum of pain intensity differences (SPID) were also similar in the early period after pain development and drug dosing. The safety of tramadol/acetaminophen was well tolerated and very comparable to that of codeine/acetaminophen/ibuprofen. Conclusions: In this acute dental pain model, the onset of analgesia and analgesic efficacy of tramadol/acetaminophen was comparable to that of codeine/acetaminophen/ibuprofen. These results showed that tramadol/acetaminophen was recommendable for fast and effective treatment in the management of postoperative acute pain.

• Tuberculosis and Respiratory Diseases
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• v.67 no.5
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• pp.422-429
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• 2009

Background: The discomfort caused by chronic cough, that is persistent for more than 3 weeks, causes a number of patients to seek medical attention. However, the underlying disorder often remains undetermined despite thorough examinations, and is considered to be idiopathic. This study compared the efficacy of inhaled corticosteroid with conventional cough suppressants on chronic idiopathic cough. Methods: Eligible patients with chronic idiopathic cough were randomly assigned to either the inhaled fluticasone group or the codeine plus levodropropizine oral administration group. The subjects in each group took their planned medication for 2 weeks. After the trial, comparative analyses of outcomes were performed in terms of the remnant cough (%) at the end of treatment, drug compliance, and adverse drug events. Results: Seventy-seven patients were enrolled in this randomized trial; 38 to the inhaled fluticasone group and 39 to the codeine plus levodropropizine group. The remnant cough was 41.0${\pm}$35.8% in the inhaled fluticasone group, and 32.4${\pm}$32.0% in the codeine+levodropropizine group (p=0.288). Drug compliance was 95.4${\pm}$7.4% and 81.8${\pm}$18.6% in the inhaled fluticasone and the codeine+levodropropizine group, respectively (p<0.001). Nine patients had adverse drug events in the codeine+levodropropizine group compared to one in the inhaled fluticasone group (p<0.001). Conclusion: Short-term inhaled corticosteroid is not inferior to conventional antitussive agents in controlling chronic idiopathic cough without significant adverse events.

• Proceedings of the PSK Conference
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• 2003.04a
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• pp.281.2-282
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• 2003

Recently, ‘bokbanggamchopyeon’, chinese analgesic which is carried in korea by travelers becomes a problem when they pass customs because it contains opiate alkaloids morphine and codeine. At this time, opium is assigned as narcitics in korea according to the rule concerning narcotics control, and its major component morphine and codeine too. (omitted)

• Proceedings of the Korean Society of Plant Biotechnology Conference
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• 2005.11a
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• pp.361-366
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• 2005

Opium poppy (Papaver somniferum L.) is one of the most important medicinal plants, which is used as a sole commercial source of narcotic analgesic, morphine. The transformant of opium poppy we have established by infection of Rhizobium rhizogenes (formerly Agrobacterium rhizogenes) strain MAFF03-01724 showed aberrant morphology and altered opium alkaloid composition. The major alkaloid produced by this transformant was thebaine (16.3%, opium dry weight) instead of morphine. It is likely that this 'thebaine poppy' phenotype was caused by the integration of T-DNA(s) into the poppy genome DNA, and their inserted loci are of great interest. To gain an insight into the mechanism of nonnarcotic thebaine accumulation for the further approach toward the creation of 'codeine poppy' which produces codeine as a major alkaloid, the genetical and morphological analyses on the transformant was carried out. Here we report the results of the detailed analysis on the T-DNA inserted loci of T0 transfromant and the correlation between opium alkaloid composition and segregated T-DNA integration pattern in the self-pollinated T1 transformants.

• Toxicological Research
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• v.5 no.1
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• pp.17-25
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• 1989

Chronic adminstraction of morphine to adult male rats has long been known to lower hepatic cytochrome p-450 content and its dependent mixed-function oxidase activity. Following the treatment of adult male rats with morphine, pethidine pentazocine and codeine and also by concomitant adminstration of naloxone activities of microsomal electron transfer in the adult male rats were examined. In present study, the acute treatment of mature male rats with a dose of narcotic drugs higher than that used chronically also reduces their hepatic cytochrome p-450.

• Korean Journal of Clinical Pharmacy
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• v.21 no.1
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• pp.30-35
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• 2011

The objective of this study was to find out drug use pattern of narcotic analgesics in university hospitals in Korea. A university hospital located in Kyungbuk province was chosen for this study. The drug use pattern was analyzed in terms of ingredient, administration route, patient type, and attending department. Amount of drug usage was counted by unit dose defined by the number of ampule or vial for injectable, tablet or capsule for oral, and each for patch preparations. Result showed that 11 narcotic analgesic ingredients were used during 2007-2009, and the drug usage was increased by about 20% annually during the period. Proportion of oral preparations used for pain management was about two third of all narcotic analgesics usage and kept increasing during the period. Proportion of the drug usage for outpatients was also steadily increased. Notably, the usage of oral preparations of oxycodone, morphine, and hydromorphone was rapidly increased for the management of cancer pain while the usage of codeine and codeine-containing composite preparations for cancer pain were minimal (<10%). About 90% of all narcotic analgesics were used by physicians in Internal Department, especially in Oncology Division of the Department. These findings suggest that pain management is becoming more aggressive and in agreement with WHO's guidelines regarding selection of administration route. However, in terms of 3-step ladder for cancer pain management, the drug use pattern was not congruent to WHO's guidelines. Therefore, in conclusion, it appears that physicians need to try to be congruent to the guidelines when using narcotic analgesics for cancer pain.

• YAKHAK HOEJI
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• v.42 no.3
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• pp.257-264
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• 1998

5-Methylthebaine was obtained by treating thebaine with n-butyllithium and methylfluorosulfonate. Hetero Diels-Alder reaction of thebaine and 5-methylthebaine with trifluoroacet aldehyde afforded 14-${\beta}$-(triflu-oro-2-hydroxyethyl)codeine (2) and 14-${\beta}$-(trifluoro-2-hydroxyethyl)-5-methylcodeinone (9). 6-${\alpha}$-OH compound (4) was obtained by employing $CeCl_2$ and $NaBH_4$. After synthesized a derivative substituted for 3-OH (5), using boron tribromied, We synthesized a new derivative that make double bond in C-7, C-8 into epoxode (6), (10). Through inspecting an influence on structure-activity and analgetic action, we are going to examine which opiold acceptor has a selectivity.

• Proceedings of the PSK Conference
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• 2002.10a
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• pp.394.3-395
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• 2002

Dextromethorphan (Romilar. DEX) is a synthetic analogue of codeine. is not classified as a narcotic and is used only for its antitussive effects in Korea. The daily intake by adults range up to 120mg. Usually in the case of traffic accident. alcohol concentration of blood is analyzed in Korea. but drug tests (medicine, narcotic. alcohol) are submitted in Australia. In crimes of violence (2 examples), a traffic and a murder accident. drug testing in urine and blood was performed. (omitted)