Home Drug Guide Meperidine Hydrochloride

Drug Guide

Generic Name

Meperidine Hydrochloride

Brand Names Demerol, Meperidine Hydrochloride Preservative Free

Classification

Therapeutic: Analgesic

Pharmacological: Opioid Agonist

FDA Approved Indications

  • Moderate to severe pain

Mechanism of Action

Meperidine binds to mu-opioid receptors in the central nervous system, altering the perception and response to pain, and producing analgesia, sedation, and euphoria.

Dosage and Administration

Adult: 25-50 mg every 3-4 hours as needed; maximum dose varies depending on clinical scenario but generally not exceeding 600 mg per day.

Pediatric: Dosing based on weight; typically 1-1.5 mg/kg every 3-4 hours as needed, not to exceed adult dose.

Geriatric: Start at lower end of dosing range, monitor closely due to increased sensitivity and risk of adverse effects.

Renal Impairment: Use with caution; dose adjustments may be necessary due to accumulation of active metabolites.

Hepatic Impairment: Use with caution; monitor for increased sedation and toxicity.

Pharmacokinetics

Absorption: Rapidly absorbed after IM, subcutaneous, or oral administration.

Distribution: Widely distributed; crosses blood-brain barrier and placenta.

Metabolism: Largely hepatic metabolism; metabolized to normeperidine, an active and toxic metabolite.

Excretion: Renal elimination of parent drug and metabolites.

Half Life: Approximately 3-5 hours for meperidine; 15-30 hours for normeperidine.

Contraindications

  • Severe respiratory depression
  • Acute or severe asthma
  • Known hypersensitivity to opioids

Precautions

  • Use with caution in elderly, hepatic or renal impairment
  • History of seizures or concurrent use of serotonergic drugs (risk of serotonin syndrome)
  • Risk of dependency, abuse, and addiction

Adverse Reactions - Common

  • Dizziness (Common)
  • Sedation (Common)
  • Nausea (Common)
  • Vomiting (Common)

Adverse Reactions - Serious

  • Respiratory depression (Serious)
  • Seizures (Serious (especially with normeperidine accumulation))
  • Serotonin syndrome (Serious when combined with serotonergic agents)

Drug-Drug Interactions

  • Monoamine oxidase inhibitors (may increase the risk of serious adverse reactions)
  • Serotonergic drugs (SSRIs, SNRIs) due to serotonin syndrome risk
  • CNS depressants (enhanced sedative effects)

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor respiratory status, level of sedation, and pain relief.

Diagnoses:

  • Impaired respiratory function
  • Risk for injury related to sedation and dizziness

Implementation: Administer drug as prescribed, monitor patient response, and assess pain levels. Be vigilant for signs of respiratory depression.

Evaluation: Assess effectiveness of pain relief and monitor for adverse effects.

Patient/Family Teaching

  • Do not operate heavy machinery or drive until sedation wears off.
  • Report any signs of difficulty breathing, excessive sedation, or allergic reactions.
  • Avoid alcohol and other CNS depressants.
  • Take medication exactly as prescribed.

Special Considerations

Black Box Warnings:

  • Respiratory depression can be life-threatening.
  • Risk of abuse and dependence.

Genetic Factors: Genetic variability can affect metabolism and response.

Lab Test Interference: None known.

Overdose Management

Signs/Symptoms: Respiratory depression, pinpoint pupils, unconsciousness, hypotension.

Treatment: Administer opioid antagonist naloxone, provide supportive respiratory and cardiovascular care, ventilatory support if necessary.

Storage and Handling

Storage: Store in a tightly closed container at controlled room temperature, away from light and moisture.

Stability: Stable under recommended conditions; check expiration date before use.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.