| Drug Index |
| GENERIC NAME : |
| meperidine |
| BRAND NAMES : |
| Demerol, Mepergan |
| STREET NAMES : |
| demmies, pethidine |
| BRIEF DESCRIPTION : |
| Meperidine is a synthetic narcotic analgesic (painkiller) and sedative that binds to the mu (µ) opiate receptors. It is an opioid agonist. It is considered a central nervous system depressant. Its actions are qualitatively similar to morphine. Its onset of action is more rapid than morphine, but the duration of action is slightly shorter. Meperidine is supplied in tablets of 50 mg or 100 mg and in a liquid form 50 mg/5 mL. Mepergan is a combination of 50 mg of meperidine and 25 mg of promethazine (Phenergan). |
| INDICATIONS FOR USE : |
| Meperidine is indicated for the treatment of pain or for sedation. |
| ABUSE AND ADDICTIVE POTENTIAL : |
Use of meperidine poses a risk for abuse or dependence. It should be used with caution in patients with a history of alcohol or substance dependence as this may highly predispose to becoming addicted to this drug. A symptom that is easily detected with opiate use is pinpoint pupils (miosis). Psychological dependence may occur early in use of this medication, but physical dependence and tolerance may develop upon repeated administration over several weeks or months (requiring larger or more frequent dosages of meperidine to produce relief of pain or achieve a state of euphoria). When meperidine is abused, the individual is seeking the euphoric effect ("high"). Methods of abuse of meperidine tablets include crushing, chewing, snorting, or in injecting the dissolved product. Mild signs of withdrawal can occur in some individuals after using meperdine for several days consecutively. Addiction to this drug can occur, even if taken as prescribed, when used for several weeks or months consecutively. When taken for treatment of chronic pain for several weeks or months consecutively, tolerance and dependence often occur. Once an individual has become dependent on meperidine, a primary driving force to continue using meperidine (or substituting other opiate agonists) is to prevent the very unpleasant neurochemical and physical withdrawal syndrome associated with discontinuing this drug. Symptoms usually associated with withdrawal may include:
(Note: the term "going cold turkey" comes from the goose-flesh that occurs during withdrawal that looks like the skin of a plucked turkey) Withdrawal of meperidine is best handled by a physician that is skilled at assisting patients with opiate detoxification. Medications are often necessary to help control symptoms of withdrawal.
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| OVERDOSAGE : |
| Acute overdose of meperidine can cause respiratory depression, extreme drowsiness or prolonged sleeping, stupor or coma, muscle flaccidity, cold/clammy skin, constricted pupils, slow heart rate (bradycardia), low blood pressure (hypotension), and death. When meperidine is used in combination with alcohol or other central nervous system depressants, the two drugs potentiate one another and can greatly enhance the risk for overdose. Because of the dangers associated with overdose, immediate medical attention should be sought. |
| CAUTIONS : |
| Any patient with a history of alcohol or substance dependence has a very high risk for developing addiction to meperidine. If use of this medication is considered necessary for the management of pain in an addict or alcoholic, the lowest dose of this medication that is sufficient to provide pain relief is warranted. It is also recommended that use of this medication in an addict be discontinued as soon as possible and pain management thereafter managed with non-addictive medications. Respiratory depression is one of the chief hazards from all opioid agonist medications. Caution should be exercised when prescribing this medication to individuals with impaired lung function or low blood pressure. There may be serious problems also with use of this medication an individual with a closed head injury. It can elevate cerebrospinal fluid pressure and mask symptoms of closed head injury that could require immediate medical measures. The administration of meperidine, like all opioid analgesics, may obscure the diagnosis or clinical course in patients with acute abdominal conditions. Meperidine should be used in caution in patients with a history of atrial flutter or other supraventricular tachycardias (heart arrhythmias)because of a possible vagolytic effect of this medication. Meperidine may aggravate seizures in patients with convulsive disorders. Individuals with kidney (renal) or liver (hepatic) impairment must be monitored closely because the concentration of meperidine in the bloodstream can be higher than in subjects with normal kidney or liver function. Use of meperidine with other sedative/hypnotic drugs, opiates (narcotics), muscle relaxers, sedating "street drugs", or alcohol can cause a multiplied effect of the potency of each drug. Taking these types of drugs with meperidine is considered dangerous. There are also other prescription medications that may interact negatively with meperidine. Certain medications may either increase or decrease plasma level of meperidine when used together. Use of alcohol, drugs, or other medications should be discussed with your physician or pharmacist before using meperidine. |
| SIDE EFFECTS : |
| Side effects of meperidine use may include nausea, constipation, vomiting, headache, and itching (pruritus), hypotension (low blood pressure). Adverse effects may include allergic reaction, irregular heartbeat, migraine, confusion, temporary hallucination, dry mouth, nervousness, tremor, rash, blurred vision, mental clouding, lethargy, mood changes, urinary retention, anxiety, fear, respiratory depression, and personality changes. |
| FOR MORE INFORMATION : |
| *This is a condensed description of meperidine. For more details check with your physician, pharmacist, or resources such as The Physicians' Desk Reference (PDR) or http://www.drugs.com. |
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