Analgesic
Meperidine
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Meperidine
, Demerol
Indications
Other
Narcotic Analgesic
s are preferred
See disadvantages below (e.g. accumulation)
Consider when only 1-2 doses required
Suppresses rigors and shivering
Amphotericin
Therapeutic Hypothermia
Pharmacokinetics
Onset: 10 to 15 minutes
Peak: 30 to 50 minutes
Duration: 2 to 4 hours
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
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
Does not potentiate Meperidine
Vistaril
requires intramuscular dosing (sclerosing)
Only indicated for Meperidine induced
Nausea
(20%)
Consider alternative intravenous
Antiemetic
Example:
Phenergan
Dose only as needed for
Nausea
or
Emesis
Disadvantages
Toxic metabolites
Neurotoxic metabolites (e.g.
Seizure
risk)
Clark (1995) J Emerg Med 13(6):797 [PubMed]
Weak
Analgesic
compared with other
Narcotic
s
Accumulates in
Renal Failure
(avoid in the elderly)
Psychomimetic effects (Dysphoria or Euphoria)
Poor oral absorption
Advantages
Serotonin
reuptake inhibitor
Suppresses rigors and shivering
Amphotericin
Therapeutic Hypothermia
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