Pethidine tolerance

Aspirin, paracetamol, and hydrocortisone are used to control febrile reactions of amphotericin. Patients with a history of adverse effects with amphotericin should be prophylactically treated with antipyretics and hydrocortisone. Antiemetics and pethidine also are used for the treatment of adverse effects of amphotericin. With sodium supplements and hydration therapy, damage to the kidney can be reduced. If conventional amphotericin is not well tolerated by the patient, colloidal carriers can be used as alternative options. Administration of amphotericin with a nephrotoxic drug, such as cyclosporin, may further increase toxicity. Diuretics and anticancer drugs should be avoided with amphotericin. 

In potency, pethidine is graded between codeine and morphine (50-100 mg is equivalent to 10 mg morphine in man),(2) and it is useful for the management of mild to moderate pain, especially in patients intolerant to opioids. Its toxicity is relatively low and its duration of action is somewhat shorter than that of morphine. At equivalent dosage, pethidine is at least as depressant as morphine upon respiration and while morphinelike side effects such as nausea and vomiting frequently occur, it produces little disturbance of urinary function or bowel action. It is extensively used for the relief of labor pain even though it increases the incidence of delay on the first breath and cry of the neonate (3) several critical reports on the efficacy of the drug in obstetrics have been made.(4) Tolerance to pethidine develops slowly, and its dependence liability is claimed to be lower than that of morphine.(5) Full accounts of the clinical use of pethidine are available.(4,6)... 

Pethidine dependence occurs, with some tolerance, especially to the side-effects, but its psychic effects are less constant and less marked than those of morphine. Pethidine has evident advantages over morphine for pain that is not very intense, and it is... 

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