section name header

Pronunciation

me-PER-i-deen

Classifications

Therapeutic Classification: opioid analgesics

Pharmacologic Classification: opioid agonists

Indications

BEERS REMS, High Alert


Unlabeled Use:
  • Rigors.

Action

  • Binds to opiate receptors in the CNS. Alters the perception of and response to painful stimuli while producing generalized CNS depression.
Therapeutic effects:
  • Reduction in severity of pain.

Pharmacokinetics

Absorption: 50% from the GI tract; well absorbed from IM sites. Oral doses are about half as effective as parenteral doses. IV administration results in complete bioavailability.

Distribution: Widely distributed to tissues.

Metabolism/Excretion: Mostly metabolized by the liver; some converted to normeperidine, which may accumulate and cause seizures. 5% excreted unchanged by the kidneys.

Half-Life: Neonates: 12–39 hr; Infants 3–18 mo: 2.3 hr; Children 5–8 yr: 3 hr; Adults: 2.5–4 hr ( in impaired renal or hepatic function [7–11 hr]).

Time/Action Profile

(analgesia)

ROUTEONSETPEAKDURATION
PO15 min60 min2–4 hr
IM10–15 min30–50 min2–4 hr
SUBQ10–15 min40–60 min2–4 hr
IVimmediate5–7 min2–3 hr





Contraind./Precautions

Contraindicated in:

Use Cautiously in:

Adv. Reactions/Side Effects

CV: hypotension, bradycardia

Derm: flushing, sweating

EENT: blurred vision, diplopia, miosis

Endo: adrenal insufficiency

GI: constipation, nausea, vomiting

GU: urinary retention

Neuro: confusion, sedation, dysphoria, euphoria, floating feeling, hallucinations, headache, SEIZURES, unusual dreams

Resp: RESPIRATORY DEPRESSION (INCLUDING CENTRAL SLEEP APNEA OR SLEEP-RELATED HYPOXEMIA)

Misc: allodynia, HYPERSENSITIVITY REACTIONS (INCLUDING ANAPHYLAXIS), opioid-induced hyperalgesia, physical dependence, psychological dependence, tolerance

Interactions

Drug-drug:

Drug-Natural Products:

Route/Dosage

Availability

(Generic available)

Assessment

Lab Test Considerations:

Toxicity and Overdose:

Implementation

IV Administration:

Patient/Family Teaching

Evaluation/Desired Outcomes

US Brand Names

Demerol

Contr. Subst. Schedule

Schedule II (C-II)