This page was prepared by Tami Skinner, LPN Internet Nursing Guide
Michigan Nurses, Pediatrics, Respiratory, Home Health, Medical-Surgical, Long Term Care
http://www.nursefriendly.com/skinner/

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Demerol (Meperidine): The PIENO Parkinsn's List Drug Database: "Meperidine hydrocholoride is an oral and parenteral opiate agonist. In foreign countires, it is known as pethindine. Meperidine is not a natural opiate like morphine or codeine, but is a synthetic compound belonging to the phenylpiperidine class. Meperidine is recommended for relief of moderate to severe pain but also has the unique ability to interrupt postoperative shivering and shaking chills induced by amphotericin B. Meperidine is metabolized to normeperidine, a compound capable of inducing seizures if it accumulates. Unlike morphine, which was in use long before the passage of the 1938 FD&C act, meperidine was first approved by the FDA and marketed in 1942. It is a schedule C-II controlled substance and is available in both oral and parenteral forms. "
http://www.parkinsons-information-exchange-network-online.com/drugdb/079.html

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Description Of Meperidine (Demerol) with comprehensive drug information: Rx List: "Meperidine hydrochloride injectable is supplied in Carpuject with InterLink and Carpuject Sterile Cartridge-Needle Units, SmartPak Injection Delivery System of 2.5% (25 mg/1 ml), 5% (50 mg/1 ml), 7.5% (75 mg/1 ml), and 10% (100 mg/1 ml). Uni-Amp Unit Dose Pak--ampuls of 5% solution (25 mg/0.5 ml), (50 mg/1 ml), (75 mg/1.5 ml), (100 mg/2 ml), and 10% solution (100 mg/1 ml). Uni-Nest Pak--ampuls of 5% solution (25 mg/0.5 ml), (50 mg/1 ml), (75 mg/1.5), (100 mg/2 ml), and 10% solution (100 mg/1 ml). Multiple-dose vials of 5% and 10% solutions contain metacresol 0.1% as preservative.The pH of meperidine solutions is adjusted between 3.5 and6 with sodium hydroxide or hydrochloric acid."
http://www.rxlist.com/cgi/generic/meper.htm

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Overdose considerations concerning Demerol (Meperidine) and it's use: HeadachePainFree.Com: "'Even patients with no known risk factors may develope Meperidine-induced toxicity' 'For more than 10 years, clinical practice guidelines, such as those developed by the American Pain Society, have included warnings about the hazards of meperidine use in pain management. Yet Meperidine, a short-acting morphine-like opioid, continues to be the parenteral opioid most frequently prescribed for moderate to severe pain.'"
http://www.headachepainfree.com/meperidine.htm

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Demerol (Meperidine) Toxicity: Health Central: "Children are more susceptible to some of the side effects of these medications including: breathing problems excitability restlessness Children should not receive more than the prescribed amount. Do not double up the dose or increase the dose without consulting with a health care provider. Use a calibrated medicine spoon to administer the liquid medication to assure accuracy. Sedation is a common side effect, physical activities that require mental alertness should be avoided. These compounds can cause constipation; fiber or a stool softener may be needed."
http://www.healthcentral.com/mhc/top/002624.cfm

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Demerol (Meperidine) Use; a study of complience with national guidelines: The Good Drug Guide: "The Agency for Health Care Policy and Research (AHCPR) established guidelines for the use of meperidine (demerol), a common inpatient analgesic. These guidelines define standards of care for acute and chronic cancer pain management and address many of the problems with meperidine and its metabolite, normeperidine. The purpose of this study was to determine whether meperidine was prescribed in compliance with AHCPR guidelines, whether patients exhibited any adverse reactions to meperidine, and to determine the analgesic efficacy of meperidine."
http://www.opioids.com/meperidine/index.html

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Meperidine (Demerol) Pain Control Issues "The Passing of Demerol": West Virginia Cancer Pain Initiative: "Meperidine (Demerol) has been the traditional analgesic drug for many years. Several misconceptions have lead meperidine to the established place as the standard agent for pain control. In truth, Meperidine is distinctly inferior for pain control, an irritant at the site of injection, ineffective orally, and has a dangerous toxic metabolite which can accumulate at standard doses. Serious questions must be raised about the continued use of Meperidine view of its poor effectiveness and high incidence of serious side effects."
http://ruralnet.marshall.edu/pain/demerol.htm

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Demerol (Meperidine); Nursing Considerations: Midwest Anesthesia Consultants: "On this page, you will find information which will enable YOU as the clinical nursing expert, to have physician orders changed to safer alternatives for your patient's pain. When your rational for requesting the change from Demerol to another opioid is clear and scientifically based, most physicians will listen. Three hundred inpatient charts were reviewed and identified meperidine as the primary analgesic in 157 nonobstetric inpatients. Age, sex, weight, dosing interval, route of administration, duration of meperidine use, serum chemistry values, primary diagnosis, associated medical conditions, and medications concurrently being taken with meperidine were the parameters analyzed."
http://www.jackstem.com/demerol_dangers.htm ******************************************************

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