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.
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 .
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