Name: MEPERIDINE (Pethidine, DemerolR)
Classification: narcotic analgesic
  • may be used in patients with morphine allergies
  • may be used to decreased shivering
Dose:
  • Bolus dose:
    • 5-15mg IV direct
Administration:
  • give analgesia before peak pain
Adverse Effects:
  • hypotension
  • respiratory depression
  • decreased gastrointestinal motility; constipation
  • inhibits voluntary cough, increased secretion retention; patients should be encouraged to cough
  • seizures, tremors, myoclonic jerks (dose related effect or occurs if given in the presence of renal failure)
Antidote:
  • naloxone:  0.1-0.4mg IV (see naloxone monograph)
Caution:
  • should be used with caution in patients with renal failure as accumulation of active metabolite, normperidine, can occur, significantly increasing the risk of CNS toxicity
Drug Interactions:
  • meperidine + CNS depressants = enhanced CNS depressant effect
  • meperidine + MAO Inhibitors = severe, sometimes fatal reaction: excitation, sweating, rigidity, BP, respiratory depression, coma, seizures, hyperpyrexia 
  • meperidine + chlorpromazine = seizures
  • meperidine + phenytoin = decreased meperidine elimination and increased analgesic effect
Contraindications:
  • contraindicated within 14-21 days of MAO Inhibitors
Monitoring Therapy:
  • HR
  • BP
  • respiratory rate
  • analgesic response
CCTC Protocol:
  • May be administered IV direct by an approved nurse in the CCTC providing that each dose is 25mg or less.


Lynne Kelly, Pharmacist, CCTC
Brenda Morgan, Clinical Nurse Specialist, CCTC
Last Update: August 7, 2006

LHSCHealth Professionals

Last Updated March 24, 2009 | © 2007, LHSC, London Ontario Canada