Meperidine hydrochloride ( Pethedine hydrochloride

dr.joan

Meperidine hydrochloride ( Pethedine hydrochloride) :
Trade names: Demerol

Class: Narcotic analgesic, synthetic.

Pregnancy: (Category B / D if used for prolonged periods or in high doses at term)

Action:

· It has no antitussive effect.
· The duration of action is less than that of opium.
Uses:
· Sever pain.
· Renal & hepatic colic.
· Obstetric Preanasthetic medication.
· In minor surgeries.
· Spasm of GI tract, uterus.
· Prior some diagnostic procedures e.g. cystoscope.
· Post operative pain.

Dose:

· Acute pain, By subcutaneous or intramuscular injection, 25–100 mg, repeated after 4 hours; CHILD, by intramuscular injection, 0.5–2 mg/kg
By slow intravenous injection, 25–50 mg, repeated after 4 hours
· Obstetric analgesia, by subcutaneous or intramuscular injection,
50–100 mg, repeated 1–3 hours later if necessary; max. 400 mg in
24 hours
· Premedication, by intramuscular injection, 25–100 mg 1 hour before operation; CHILD 0.5–2 mg/kg
· Postoperative pain, by subcutaneous or intramuscular injection, 25–100 mg, every 2–3 hours if necessary; CHILD, by intramuscular injection, 0.5–2 mg/kg

Note.
[IMG]file:///C:/DOCUME~1/hazem/LOCALS~1/Temp/msohtmlclip1/01/clip_image001.gif[/IMG] In the postoperative period, the patient should be closely monitored for pain relief as well as for side-effects especially respiratory depression

Contraindications:
· Hypersensitivity.
· Convulsive states.
· Children less than 6 months.
· Head injuries.
· Diabetic acidosis.
Side effects:
· Respiratory depression , apnea, dizziness, euphoria headache, mental clouding, insomnia nausea, vomiting, constipation, dry mouth, skin rashes, laryngospasm, urinary retention, and decreased libido.

Nursing considerations:
· Use supportive nursing measures as relaxation techniques to relieve pain before using narcotics.
· Explore the source of pain, use non-narcotic analgesia if possible.
· Administer the medication when needed, prolonging the medication administration will decrease the effect of the medication.
· Monitor vital signs & mental status.
· Monitor Respiratory rate (drug may lead to respiratory depression).
· Monitor blood pressure ( hypotension may occur)
· Monitor pulse rare (if 60\m withhold the drug).
· Watch for constricted pupils. Document it and notify the physician.
· Monitor bowel function, since drug may cause constipation .
· Encourage client to empty bladder every 3-4 hrs (since drug may cause urinary retention).
· If client is bed ridden, use side rails.
· Inform the client\family that the drug may become habit forming and leading to addiction.
· Document any history of asthma or other contraindications.

Have emergency equipment and narcotic antagonist available .