| Name: |
MEPERIDINE (Pethidine, DemerolR) |
| Classification: |
narcotic analgesic
- may be used in patients with morphine allergies
- may be used to decreased shivering
|
| Dose: |
|
| 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.
|
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