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This polymorphism is a loss\u2010of\u2010function variant, leading to impaired metabolism of morphine.<\/jats:p><\/jats:sec><jats:sec><jats:title>Mechanism<\/jats:title><jats:p>Morphine is metabolized by UDP\u2010glucuronosyltransferase (UGT)\u20102B7 and UGT1A1 to form its major metabolites morphine\u20103\u2010glucuronide (M3G) and morphine\u20106\u2010glucuronide (M6G). Our patient was a poor metabolizer through UGT1A1, likely leading to increased respiratory depression as morphine has greater respiratory depressant effects compared to its metabolites.<\/jats:p><\/jats:sec><jats:sec><jats:title>Implications<\/jats:title><jats:p>When appropriate, physicians should enquire about prior receipt of opioids, in both the patient and family, to be better prepared for potential adverse reactions. In the patient with excessive sedation or respiratory depression to standard doses of morphine, genetic testing may be warranted, especially if there is a family or past history that supports a metabolic defect in morphine metabolism and\/or excretion.<\/jats:p><\/jats:sec>","DOI":"10.1111\/bcp.13779","type":"journal-article","created":{"date-parts":[[2018,11,13]],"date-time":"2018-11-13T04:05:34Z","timestamp":1542081934000},"page":"258-262","source":"Crossref","is-referenced-by-count":8,"title":["Prolonged central apnoea after intravenous morphine administration in a 12\u2010year\u2010old male with a <i>UGT1A1<\/i> loss\u2010of\u2010function polymorphism"],"prefix":"10.1111","volume":"85","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7013-5432","authenticated-orcid":false,"given":"Michael S.","family":"Toce","sequence":"first","affiliation":[{"name":"Division of Emergency Medicine, Boston Children's Hospital, Department of Pediatrics Harvard Medical School  Boston MA 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