II. Indications
- Other Narcotic Analgesics are preferred
- See disadvantages below (e.g. accumulation)
- Consider when only 1-2 doses required
- Suppresses rigors and shivering
- Amphotericin
- Therapeutic Hypothermia
III. Pharmacokinetics
- Onset: 10 to 15 minutes
- Peak: 30 to 50 minutes
- Duration: 2 to 4 hours
IV. Dosing: Child
- Dose: 0.25-1.0 mg/kg (up to 1.8 mg/kg has been used max: 100 mg) IM q3-4 hours
V. Dosing: Adult
- Dose: 50 to 100 mg (or 1-1.5 mg/kg) IM q3-4 hours
- Dose per weight (default dosing often too low)
- Intravenous dosing preferred over intramuscular
- No dosing adjustment needed for IV versus IM
- Dosing frequency is often dosed too infrequently
- Duration of action is only 3 hours
- Avoid more than 2-3 doses due to accumulation
- Often administered with Hydroxyzine (Vistaril)
- Vistaril 25 to 50 mg (0.5 mg/kg) IM q4-6 hours
- Vistaril no longer routinely recommended
- Consider alternative intravenous Antiemetic
VI. Disadvantages
- Toxic metabolites
- Neurotoxic metabolites (e.g. Seizure risk)
- Clark (1995) J Emerg Med 13(6):797 [PubMed]
- Weak Analgesic compared with other Narcotics
- Accumulates in Renal Failure (avoid in the elderly)
- Psychomimetic effects (Dysphoria or Euphoria)
- Poor oral absorption
VII. Advantages
- Serotonin reuptake inhibitor
- Suppresses rigors and shivering
- Amphotericin
- Therapeutic Hypothermia
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Related Studies
| meperidine (on 10/19/2016 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
| MEPERIDINE 100 MG TABLET | Generic | $1.09 each |
| MEPERIDINE 50 MG TABLET | Generic | $0.64 each |
| MEPERIDINE 50 MG/5 ML SOLUTION | Generic | $0.18 per ml |
| demerol (on 1/1/2017 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
| DEMEROL 50 MG/ML AMPUL | $3.50 per ml | |
Ontology: Meperidine (C0025376)
| Definition (NCI) | A synthetic piperidine ester with opioid analgesic activity. Meperidine mimics the actions of endogenous neuropeptides via opioid receptors, thereby producing the characteristic morphine-like effects on the mu-opioid receptor, including analgesia, euphoria, sedation, respiratory depression, miosis, bradycardia and physical dependence. |
| Definition (MSH) | A narcotic analgesic that can be used for the relief of most types of moderate to severe pain, including postoperative pain and the pain of labor. Prolonged use may lead to dependence of the morphine type; withdrawal symptoms appear more rapidly than with morphine and are of shorter duration. |
| Definition (CSP) | synthetic narcotic analgesic used where a relatively short duration of analgesia is desired; abuse of this drug may lead to dependence. |
| Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
| MSH | D008614 |
| SnomedCT | 387298007, 54544005 |
| LNC | LP16184-1, MTHU005014 |
| English | Isonipecain, Meperidine, Pethidine, 4-Piperidinecarboxylic acid, 1-methyl-4-phenyl-, ethyl ester, Meperidine [Chemical/Ingredient], pethidine, meperidine, MEPERIDINE, Meperidine (product), Meperidine (substance) |
| Swedish | Meperidin |
| Czech | meperidin |
| Finnish | Petidiini |
| Russian | MEPERIDIN, LIDOL, IZONIPEKAIN, OPERIDIN, PETIDIN, ИЗОНИПЕКАИН, ЛИДОЛ, МЕПЕРИДИН, ОПЕРИДИН, ПЕТИДИН |
| Japanese | メペリジン, イソニペカイン, ペチジン |
| Italian | Petidina, Meperidina |
| Croatian | MEPERIDIN, PETIDIN |
| Polish | Dolantyna, Meperydyna, Petydyna |
| Spanish | meperidina (producto), meperidina (sustancia), meperidina, petidina, Meperidina, Petidina, Isonipecaína |
| French | Péthidine |
| German | Isonipecain, Meperidin, Pethidin |
| Portuguese | Isonipecaína, Meperidina, Petidina |
Ontology: Demerol (C0935966)
| Definition (CHV) | brand name of a strong pain medicine |
| Definition (CHV) | brand name of a strong pain medicine |
| Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
| MSH | D008614 |
| English | demerol, demerol [brand name], Demerol |
