Meperidine gastrointestinal effects

Nalbuphine is less likely to depress respiratory function than meperidine Tolerance to ocular and gastrointestinal effects develops rapidly during chronic use Mental retardation, microcephaly, and underdevelopment of the mid face region in an infant is associated with chronic maternal abuse of (A) Amphetamine Cocaine Ethanol Mescaline Phencyclidine... 

Meperidine has replaced morphine to a large extent in medical practice because of the physician s reluctance to use an opiate and the belief that meperidine manifests less undesirable side effects than does morphine. However, both of these assumptions are ill founded. Addiction to meperidine is much less amenable to treatment than is addiction to morphine. Meperidine, similar to morphine and codeine, causes spasm of the upper gastrointestinal tract and typical attacks of biliary colic in biliary tract disease. Meperidine, in doses giving an equal analgesic effect, induces as much respiratory depression as does morphine. Similar to morphine, it also crosses the placental barrier and must therefore be used cautiously in the latter stages of labor. 

Toxicity Adverse effects include insomnia, mood changes, dyskinesias, gastrointestinal distress, and hypotension. Meperidine in combination with selegiline has caused agitation, delirium, and death. Selegiline has been implicated in the serotonin syndrome when used in patients taking selective serotonin reuptake inhibitors (see Chapter 30). 

Approximately 50% of oral meperidine is absorbed into the systemic circulation (range 41 to 61%). After oral administration the onset of analgesia is within 15 minutes and peak effects occur in 60-90 minutes [1,3]. In hepatic disease, with reduced hepatic clearance, the absorption of meperidine is increased from the gastrointestinal tract, necessitating a reduced dose. 

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