Pethidine Barbiturates

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

Pethidine Hydrochloride Pethidine hydrochloride solutions are not compatible with barbiturates, aminophylline, morphine sulfate, sulfadiazine sodium, methicilline sodium, nitrofurantoin, phenytoin sodium, heparin sodium, sodium iodide, diethanolamine, sulfafurazol, acyclovir sodium, liposomal doxorubicin hydrochloride, frusemide, imipenem, and idarubicin. Visual incompatibilities are reported with mixtures of pethidine hydrochloride and cefoperazone sodium or mezlocillin sodium, nafcillin sodium and minocycline hydrochloride or tetracycline hydrochloride in 5% glucose injection.82 83... 

All compounds that behave as narcotic analgesics characterized by the usual criteria contain a basic nitrogen center that either forms parts of an alicyclic ring system, as in morphine and pethidine, or terminates an acyclic chain, as in methadone, etonitazene, and the enkephalins. Nonbasic compounds of high activity in antinociceptive tests invariably fail to satisfy criteria for narcotic analgesics, such as reversal of effects by naloxone or nalorphine or evidence of binding to opioid receptors recent examples are the barbiturate... 

OPIOIDS ANTIEPILEPTICS 1. Barbiturates T sedative effects of opioids 2.1 efficacy of fentanyl and methadone with carbamazepine, phenobarbital, phenytoin or primidone 3. Carbamazepine l tramadol levels 4. Risk of pethidine toxicity 1. Additive sedative effect 2. t hepatic metabolism of fentanyl and methadone, and possibly an effect at the opioid receptor 3. Carbamazepine T metabolism of tramadol 4. Phenytoin induces metabolism of pethidine, which causes T level of a neurotoxic metabolite 1. Monitor respiratoiy rate and conscious levels 2. Be aware that the dose of fentanyl and methadone may need to be t 3. Watch for poor effect of tramadol. Consider using an alternative opioid 4. Co administer with caution the effect may be i by administering pethidine intravenously... 

GC-MS methods provide greater specificity and in many cases sensitivity when compared with more conventional techniques. They offer increased scope for the study of pharmacokinetics and of plasma concentration in relation to biological effect. SIM assay has been applied to the investigation of placental transfer of lipid soluble drugs and their subsequent elimination in the newborn (barbiturates, diphenylhydantoin, caffeine, pethidine and diazepam [122,408] diphenylhydantoin [411] amylobarbitone and 3 -hydroxyamylobarbitone [83,423]). 

Special arrangements apply to the prescribing of drugs of dependence in the UK under the provisions of the Misuse of Drugs Act 1971. Drugs controlled include cocaine, dipipanone, diamorphine (heroin), methadone, morphine, opium, pethidine, phencyclidine, lysergjde (LSD), amphetamines, barbiturates, cannabis, codeine, pholcodine, and certain drugs related to the amphetamines, such as chlorphentermine and diethylpropion. 

A single case report describes greatly increased sedation with severe CNS toxicity in a woman given pethidine after she took phe-nobarbital for two weeks. The analgesic effects of pethidine can be reduced by barbiturates. Secobarbital increases the respiratory depressant effects of morphine. Other barbiturates would also be expected to increase the CNS depressant effects of opioids. 

Studies suggest that phenobarbital stimulates the liver enzymes concerned with the metabolism (A/-demethylation) of pethidine so that the production of its more toxic metabolite (norpethidine) is increased. The toxicity seen appears to be the combined effects of this compound and the directly sedative effects of the barbiturate. "... 

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