Barbiturates Meperidine

SKF 525-A inhibits the in vitro metabolism of several barbiturates, meperidine, aminopyrine, and codeine, the formation of morphine glucuronide, and the hydrolysis of procaine and ethylglycinexylidide. However, SKF 525-A has no significant effect on the microsomal N-demethylation of monomethyl-4-aminoantipyrine, N-methylaniline or 3-methyl-4-monomethylaminoazobenzene, the O-dealkylation of phenacetin, the hydroxylation of acetanilide, or the sulphoxidation of chlorpro-mazine. 

Examples narcotics such as meperidine, methadone, morphine, oxycodone amphetamines and barbiturates... 

Phenytoin interacts widi many different drugp. For example isoniazid, chloramphenicol, sulfonamides, benzodiazepines, succinimides, and cimetidine all increase phenytoin blood levels. The barbiturates, rifampin, theophylline, and warfarin decrease phenytoin blood levels. When administering the hydantoins with meperidine, die analgesic effect of meperidine is decreased. 

Lopinavir/Ritonavir (Kaletra) [Anrirelroviral/Protease Inhibitor] Uses HIV Infxn Action Protease inhibitor Dose Adults. Tx naive 2 tab PO daily or 1 tab PO bid Tx experiencedpt 1 tab PO bid (T dose if w/ amprenavir, efavirenz, fosamprenavir, nelfinavir, nevirapine) Peds. 7-15 kg 12/3 mg/kg PO bid 15-40 kg 10/2.5 mg/kg PO bid >40 kg Adult dose w/ food Caution [C, /-] Numerous interactions Contra w/drugs dependent on CYP3A/CYP2D6 (Table VI-8) Disp Tab, soln SE Avoid disulfiram (soln has EtOH), metronidazole GI upset, asthenia, T cholesterol/triglycerides, pancreatitis protease metabolic synd Interactions T Effects Wl clarithromycin, erythromycin T effects OF amiodarone, amprenavir, azole andfungals, bepridil, cisapride, cyclosporine, CCBs, ergot alkaloids, flecainide, flurazepam, HMG-CoA reductase inhibitors, indinavir, lidocaine, meperidine, midazolam, pimozide, propafenone, propoxyphene, quinidine, rifabutin, saquinavir, sildenafil, tacrolimus, terfenadine, triazolam, zolpidem 1 effects Wl barbiturates, carbamazepine, dexamethasone, didanosine, efavirenz, nevirapine, phenytoin, rifabutin, rifampin, St. John s wort 1 effects OF OCPs, warfarin EMS Use andarrhythmics and benzodiazepines... 

T effects OF amiodarone, astemizole, atorvastadn, barbiturates, bepridil, bupropion, cerivastatin, cisapride, clorazepate, clozapine, clarithromycin, desipramine, diazepam, encainide, ergot alkaloids, estazolam, flecainide, flurazepam, indinavir, ketoconazole, lovastatin, meperidine, midazolam, nelfinavir, phenytoin, pimozide, piroxicam, propafenone, propoxyphene, quinidine, rifabutin, saquinavir, sildenafil, simvastatin, SSRIs, TCAs, terfenadine, triazolam, troleandomycin, zolpidem X effects W/ barbiturates, carbamazepine, phenytoin, rifabutin, rifampin, St. John s wort, tobacco X effects OF didanosine, hypnotics, methadone, OCPs, sedatives, theophylline, warfarin EMS T Effects of amiodarone, diazepam, midazolam and BBs, may need X- doses concurrent use of Viagra-type drugs can lead to hypotension X- effects of warfarin concurrent EtOH use can T adverse effects T glucose ODs May cause an extension of adverse SEs symptomatic and supportive Rivasrigmine (Exelon) [Cholinesterase Inhibitor/Anri ... 

Frequently, a preoperative sedative is given to a patient 1 to 2 hours before the administration of general anesthesia.2,36 Sedatives are usually administered orally or by intramuscular injection, and are given while the patient is still in his or her room. This approach serves to relax the patient and reduce anxiety when arriving at the operating room. Commonly used preoperative sedatives include barbiturates (secobarbital, pentobarbital), opioids (butorphanol, meperidine), and benzodiazepines (diazepam, lorazepam) (Table 11-2). Different sedatives are selected depending on the patient, the type of general anesthesia used, and the preference of the physician. 

The use of opiates in obstetrical analgesia is a highly specialized field requiring considerable experience and sound judgment to ensure safety. Morphine has been combined with scopolamine in twilight sleep, but this mixture is not used nearly as much as formerly. Various combinations of meperidine, barbiturate, scopolamine, paraldehyde, and the inhalation anesthetics have made morphine less popular in obstetrical work. The opiates are powerful respiratory depressants. The fetus is especially susceptible to morphine, which greatly increases the incidence of asphyxia in the newborn. Morphine and its derivatives are particularly contraindicated in premature labor because of the untoward effect of such medication on the premature infant. 

Naloxone (Narcan) and naltrexone hydrochloride (Trexan) reverse the respiratory depressant action of narcotics related to morphine, meperidine, and methadone. They differ from other narcotic analgesics in several respects. Naloxone does not cause respiratory depression, pupillary constriction, sedation, or analgesia. However, it does antagonize the actions of pentazocine. Naloxone neither antagonizes the respiratory depressant effects of barbiturates and other hypnotics nor aggravates their depressant effects on respiration. Similar to nalorphine, naloxone precipitates an abstinence syndrome when administered to patients addicted to opiate-like drugs. 

Pethidine see Meperidine Peyote see Mescaline Phendimetrazine see Diet pills Phenelzine see Antidepressants Phenobarbital see Barbiturates Phentermine see Diet pills... 

Subsequently, Purdie and coworkers studied the CD induced in phencyclidine (and its pyrrolidine and morpholine analogues), 6-phenethylamine, phenobarbital, meperidine HC1, diazepam, and dilantin by 6-cyclodextrin [59], In this work, a method was described for the assay of meperidine in commercially available Demerol tablets. The complexation between 6-cyclodextrin and eight 5,5-disubstituted derivatives of barbituric acid was characterized on the basis of the... 

SCHEDULE II Certain barbiturates, cocaine, codeine, codeine + acetaminophen (depends on dose and formulation), fentanyl (depends on dose), hydrocodone, hydromorphone, meperidine, methadone, morphine (depends on combination with other pain relievers), oxycodone, propoxyphene... 

Using a 1/8", 5, 5 SE-30 Chromosorb W column operated at 230°C. and at 2 0°C., Parker, Fontan and Kirk77 separated meperidine from other alkaloids, barbiturates, sympathomimetic amines and tranquilizers. This work was directed towards development of a screening process rather than quantitative determination. 

Prescription regulations for most CNS drugs are based on their abuse liability. The potent opioid analgesics (e.g., morphine, methadone, meperidine, fentanyl) are judged to have the highest potential for abuse, along with CNS stimulants (e.g., amphetamine, cocaine) and short-acting barbiturate (e g., secobarbital). No refills or telephone prescriptions are permissible. 

Additive effects are likely after concomitant use of nortriptyline with CNS depressants, including alcohol, analgesics, barbiturates, narcotics, tranquilizers, and anesthetics (oversedation) atropine and other anticholinergic drugs, including phenothiazines, antihistamines, meperidine, and antiparkinsonian agents (oversedation, paralytic ileus, visual changes, and severe constipation) and metrizamide (increased risk of convulsions). 

Simultaneous alimemazine, amitriptyline, amphetamine, bupivacaine, buprenorphine, clomipramine, cocaine, codeine, ethylmorphine, glafenine, meperidine, methampheta-mine, methotrimeprazine, morphine, norcodeine, nortriptyline, pentazocine Noninterfering acetaminophen, aspirin, barbiturates, benzoylecgonine, caffeine, diazepam, flunitrazepam, lidocaine, lorazepam, nalorphine, naloxone, nitrazepam, nordiaze-pam, norflunitrazepam, normorphine, oxazepam, prazepam, triazolam, zolpidem Interfering cyamemazine, desipramine, imipramine... 

W-Allylnormorphine does not antagonize the respiratory depression or the general central depression from the barbiturates. It is a specific antidote for morphine, meperidine, and methadone poisoning (Eckenhoff et al., 88). 

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