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.