International journal of clinical practice
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Int. J. Clin. Pract. · Jul 2000
ReviewCodeine analgesia is due to codeine-6-glucuronide, not morphine.
Eighty per cent of codeine is conjugated with glucuronic acid to codeine-6-glucuronide. Only 5% of the dose is O-demethylated to morphine, which in turn is immediately glucuronidated at the 3- and 6-position and excreted renally. ⋯ Poor metabolisers of codeine, those who lack the CYP450 2D6 isoenzyme for the O-demethylation to morphine, experience analgesia from codeine-6-glucuronide. Analgesia of codeine does not depend on the formation of morphine and the metaboliser phenotype.
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The use of various drug delivery systems to achieve high levels of the desired antibiotic(s) at the site of infection has become commonplace in orthopaedic and trauma units the world over. One of these techniques uses the implantation of antibiotic-impregnated beads at operation sites. ⋯ We have also shown that such beads elute the antibiotic (ceftriaxone) effectively in vitro, achieving similar or better activity when measured by zones of inhibition against various bacteria species compared with standard antibiotic discs. This technique offers a cost-effective method of treating chronic bone infections in resource-poor settings.