• Allergy, Asthma & Respiratory Disease
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• v.12 no.4
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• pp.177-183
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• 2024

Dihydrocodeine is an effective antitussive agent that inhibits the cough reflex by interacting with opioid receptors in the brain. It is easily available in pharmacies without a prescription, which may contribute to a lack of awareness about potential drug hypersensitivity reactions. In the first reported case in Korea, a 29-year-old man developed acute generalized exanthematous pustulosis (AGEP) after consuming an over-the-counter cold medicine containing dihydrocodeine. He was admitted to the Emergency Department with high fever and full-body skin rashes that appeared 3 hours after taking the medicine. His EuroSCAR AGEP score was 9, with symptoms improving upon discontinuation of dihydrocodeine and the application of topical steroids. AGEP caused by dihydrocodeine, including codeine, is very rare, with 3 cases reported worldwide. By analyzing AGEP cases due to dihydrocodeine or codeine, we identified that risk factors for the development of AGEP from dihydrocodeine include a history of psoriasis and the presence of an IL36RN mutation, which result in the activation of Th17 in the blood or the skin. In cases of AGEP caused by dihydrocodeine, it is also recommended to discontinue codeine due to cross-reactivity with dihydrocodeine. Additionally, patients with AGEP due to dihydrocodeine may be able to use other opioid classes, such as morphine or tramadol, due to low cross-reactivity.

• Korean Journal of Pharmacognosy
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• v.1 no.3
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• pp.93-99
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• 1970

There have been reported by several workers for the isolation and determination of the amine derivatives as Metbylephedrine Hydrochloride and Ephedrine Hydrochloride adopting neutralization method, steam distillation method, non-aqous titration method, ion-exchange resin method, titration method after acetylation, colorimetric method, gravimetric method, iodine titration method and gas chromatography. Those methods mentioned in above, can be practically applied for the sample which is not mixed one mith the other amine compounds. Presently, it has not shown on the isolative determination of the mixed sample of amine derivatives. In this paper, it is discussed on the isolative determination of Methylephedrine Hydrochloride as the tertiary amine compound and Ephedrine Hydrochloride as the secondary amine compound. According to the results of the experiment, it could be summarized as follows: 1. There is no time-variation on the color reaction of Methylephedrine Hydrochloride and Ephedrine Hydrochloride with the color reagent, bromcresolgreen. And Methylephedrine Hydrochloride and Ephedrine Hydrochloride, respectively, can be determined spectrophotometrically by means oft his color reaction. 2. For the isolation of Methylephedrine Hydrochloride and Ephedrine Hydrochloride from the mixed sample, Methylephedrine Hydrochloride can be eluted by chloroform, while Ephedrine Hydrochloride by the mixed solvent of chloroform and ethylalcohol (2:1), from the celite column adsorbed at pH6.4 followed by extraction with ether undersodium hydroxide alkali re action. 3. When the sample is mixed with quinine hydrochloride, dihydrocodeine bitartate, and noscapine, these mixed compounds can be eliminated by means of stram distillation. 4. When the sample is mixed with chlorpheniramine maleate, dextromethorphan hydrobromide and diphenhydramine hydrochloride, the mixed compounds can be eliminated by means of steam distillation and celite adsorption column chromatography, In conclusion, the isolative determination method for Methylephedrine Hydrochloride and Ephedrine Hydrochloride studied in this paper, indicates with the excellent reproducibility and accuracy.