Demerol action

Roger Baccus, age 23 years, is prescribed Demerol for postoperative pain. You discover in his health history on the chart that he has a history of alcohol and drug use. Determine what further assessments you would need to make Explain how Roger s answers would influence the actions that you as a nurse would take. 

Meperidine (Demerol) [C-ll] [Narcotic Analgesic] Uses Moderate/ severe pain Action Narcotic analgesic Dose Adults. 25-50 mg IV, 50-100 mg IM Peds. 1 mg/kg IV/IM (onset w/in 5 min IV and 10 min IM duration about 2 h) Caution [C, ] Contra Convulsive disorders and acute abdomen Disp Prefilled 1 mL syringes 25, 50, 75, 100 mg/mL various amps and vials oral syrup and tabs SE N/V (may be severe), dizziness, weakness, sedation, miosis, resp d ession, xerostomia (dry mouth) Interactions t CNS depression W/ opiates, sedatives/ hypnotics TCNS stimulation W/amphetamines t risk of tox W7 phenytoin EMS Pt should be receiving O2 prior to administration have resuscitation equipment and naloxone available naloxone can be used as an antidote to reverse resp depression aspirate prior to IM administration inadv tent IV admin of IM doses may cause tach and syncope mix w/ NS to make a 10 mg/mL soln and inj very slowly N/V may be sev e may premedicate w/ an antiemetic... 

Less potent opioids have fallen into disfavor because of the prominence of the untoward effects they produce when given in high doses. Meperidine hydrochloride (Demerol) causes tachycardia, while morphine produces hypotension and bronchoconstriction as a consequence of its histamine-releasing action. 

Meperidine Demerol) is a phenylpiperidine derivative of morphine that was developed in the late 1930s as a potential antichohnergic agent. It has some anticholinergic side effects that lead to tachycardia, blurred vision, and dry mouth. Meperidine is approximately one-fifth as potent as morphine and is absorbed only half as well when administered oraUy as parenteraUy. It has a rapid onset and short duration of action (2 hours), that is, approximately one-fourth that of morphine. 

Drugs derived from morphine and other opium compounds are called opiates. Today, many hundreds of opiates are known some are semisynthetic derivatives, like heroin, and others are purely synthetic, like Demerol. In general, all of the opiates produce similar effects. They differ from each other in potency, in duration of action, in how active they are by mouth, and in how much mood change they cause relative to their physical effects. Opiates that arc more potent, shorter-acting, and more active by injection lend themselves more easily to abuse. 

Woolfe, G., and MacDonald, A. The evaluation of the analgesic action of pethidine hydrochloride (Demerol). J Pharmacol Exp Ther 80 300-307,1944. 

Meperidine (Demerol) Also used to treat chills induced by amphotericin B. Like morphine. Overdose causes convulsions due to excitatory actions of metabolite. 

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