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Native American Indians are more susceptible to morphine depression of respiration than are Caucasians. We now know that codeine is metabolized to a certain degree to morphine, the analgesic effects of codeine may be modulated by the production of a morphine metabolite. Turns out that there’s a difference between Caucasians and other ethnic groups in the ability of the liver to convert codeine to morphine, so analgesia differs. So you may have to consider a pt’s failure to respond to analgesics based on racial pharmacokinetic differences. This is a major area of drug research today.
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Pharmacology Notes
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