[Correlation between pholcodine and perioperative anaphylaxis].

Abstract

A large number of individuals experiencing anaphylactic reaction to neuromuscular blocking agents have not previously been in contact with them. The search for a substance inducing sensitization to muscle relaxants has led Norwegian and Swedish scientists to pholcodine, a cough suppressant, which is widely used in Europe and worldwide. Ammonium ion is an epitope common to pholcodine and neuromuscular blocking agents and it is the basis of their cross-reactivity. Based on the results of published studies that pointed to a connection of the use of pholcodine and perioperative anaphylactic reaction, pholcodine was withdrawn from the Norwegian market and subsequent research revealed a reduction of anaphylactic reactions in that country. In its latest report, the European Medicines Agency made a decision not to withdraw pholcodine mixtures from the market but it urged further research with the aim to clarify the cross-reactivity between pholcodine and neuromuscular blocking agents.

• Authors: Jelena Dumancić, Asja Stipić Marković
• Journal: Acta medica Croatica : casopis Hravatske akademije medicinskih znanosti (Acta Med Croatica) Vol. 66 Issue 2 Pg. 111-4 (May 2012) ISSN: 1330-0164 [Print] Croatia
• Vernacular Title: Povezanost folkodina i perioperativne anafilaksije.
• PMID: 23437637 (Publication Type: Journal Article, Review)

Chemical References

• Antitussive Agents
• Morpholines
• Neuromuscular Blocking Agents
• pholcodine
• Codeine

Topics

• Anaphylaxis (chemically induced, prevention & control)
• Antitussive Agents (immunology)
• Codeine (analogs & derivatives, immunology)
• Cross Reactions
• Humans
• Immunotherapy
• Intraoperative Complications (immunology, prevention & control)
• Morpholines (immunology)
• Neuromuscular Blocking Agents (immunology)
• Postoperative Complications (immunology, prevention & control)