Meperidine Hydrochloride (Demerol)

Binds with opiate receptors in the CNS, altering perception of and emotional response to pain.

 

Route

Onset of Action

Peak Effect

Duration of Action

IV

1 minutes

5-20 minutes

2-4 hours

IM

1 – 5 minutes

30-50 minutes

2-4 hours

Oral

15-45 minutes

60 minutes

2-4 hours

 

Dosage/Administration  

 

Adult:

 

25 mg slow IVP. Slowly titrate in 25 mg increments to individual patient response. Total dose for nursing administration, 100 mg in 60 minutes.

 

  • Reduce dosage and rate of administration in patients who are elderly, debilitated, having renal or hepatic disease, or who have hypothyroidism.

 

  • Contraindicated in patients on MAO inhibitors. Severe and even fatal reactions have been known to occur.

 

Pediatric

 

1 – 1.5 mg/kg. Titrate dose to individual response. Max. dose 100mg.

 

Adverse Reactions

 

  • Respiratory effects – severe respiratory depression and arrest. Use with caution in patients with COPD, asthma, corpulmonale, decreased respiratory function, hypoxia or hypercapnia.

 

  • Cardiovascular effects – orthostatic hypotension, bradycardia, tachycardia, palpitations, syncope, shock, cardiac arrest.

 

  • CNS effects – euphoria, dysphoria, weakness, sedation, convulsions, agitation, tremors, uncoordinated muscle movements, transient hallucinations, disorientation, visual disturbances.

 

  • GI – dry mouth, constipation, biliary spasm, nausea and vomiting.

 

  • Integumentary – flushing, pruritis/local tissue irritation (histamine release), uticaria, skin wheals, local irritation

 

  • GU – urinary retention

 

  • Special considerations – this drug must be titrated to effect and administered slowly to prevent the occurrence of adverse reactions.

 

Reversal Agent: 

 

Naloxone (Narcan) will reverse the respiratory and cardiovascular effects of Demerol overdose.

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