Flashcards in Meperidine Deck (24):
1
What is the trade name of Meperidine?
Demerol
2
What is the formal drug classification of Meperidine?
Synthetic Opioid Agonist
Phenylpiperidine derivative
Analgesic, Narcotic
3
What are the clinical uses of Meperidine?
-Analgesic
-Narcotic
-Used in the management of moderate to severe pain
-adjunct to anesthesia and preop sedation
-analgesia during labor and delivery
-Shares structural features of LAs and has weak local anesthetic properties
-produces same amount of euphoria, sedation, and analgesia as morphine
4
How is Meperidine effective in reducing post-op shivering from general and epidural anesthesia, __________, __________, _________ ________, and administration of _________?
stimulation of Kappa and alpha 2 receptors
Fever
Hypothermia
Transfusion Reactions
Amphotericin B
5
What is Meperidine structurally similar to? What does this do?
-Atropine!!! Possesses mild atropine-like antispasmodic effect; muscarinic effects
-also similar to local anesthetics-blocks Na channels
6
What is the MOA of Meperidine?
-Agonist at the mu & Kappa opioid receptors
-causes inhibition of ascending pain pathways, alters perception of and response to pain
-produces generalized CNS depression
-potent alpha 2 receptor agonist effects
7
How is Meperidine metabolized?
-Extensive Hepatic Metabolism
-about 90% initially undergoes demethylation to NORmeperidine (principal metabolite) and Hydrolysis to meperidinic acid
-1st pass uptake by lungs is ~65%
8
What is the terminal elimination 1/2 life of Meperidine?
3 - 5 hours
9
What is the principle route of elimination of Meperidine?
urinary excretion, pH dependent
10
What is the active metabolite of Meperidine? What is its elimination half life?
Normeperidine (has analgesic activity)
14 - 21 hours, longer than meperidine! (dr E says lasts 3 days)
likely to accumulate with repeated or prolonged administration
-1/2 as potent, CNS stimulant, Seizures reported!!!!
11
What is the Vd of Meperidine?
3.5 - 5 L/kg
12
Is Meperidine protein bound?
moderately lipid soluble; 40 - 70% protein bound
13
What are the general side effects of meperidine?
Sedation
Euphoria
N/V
Ventilation Depression as morphine
14
What are the CV effects of Meperidine?
Orthostatic Hypotension
Increased Heart rate!!! TACHYCARDIA
15
What are the CNS effects of Meperidine?
Fatigue
Drowsiness
Dizzi
nervous, HA
Sedation
Increased ICP
16
What are the dermatologic SE of Meperidine?
Rash
Urticaria
17
What are the GI/GU SE of Meperidine?
N/V
Constipation
Stomach cramps
Biliary spasm
paralytic ileus
ureteral spasm
decreased urination
18
what are the contraindications to the use of Meperidine?
-recent or concomitant MAOI use leads to life-threatening serotonin syndrome
19
What is the potency of Meperidine compared to Morphine?
1/10 the potency of morphine
20
what is the Oral, IM, SC dose of Meperidine?
50 - 150 mg q2-4 hours PRN
21
What is the IV dose of Meperidine?
5mg IV q 5 minutes...usually need approx 1/2 the IM dose 25 - 75 mg IV
22
What is the Meperidine dose for shivering?
12.5 - 50 mg IV
23
What is the Max dose daily of Meperidine?
1,000mg/ 24 hours due to increased of seizures, even in patients without renal dysfunction
24