A Drug Study on

DEMEROL

In Partial Fulfilment of the

Requirements in NCM 216 RLE
NUTRITION & GASTRO-INTESTINAL, METABOLISM & ENDOCRINE ROTATION

Submitted to:
RN, MN
Clinical Instructor

Submitted by:
, ST.N.
BSN-3A – GROUP 2

January 28, 2021

Generic Name meperidine

Brand Name Demerol

Drug Classification Opioid agonist analgesic (Pregnancy Category C, C-
II controlled substance)

Suggested Dose: For Adults:

(Oral)
- Start with DEMEROL Tablets or Oral Solution,
50 mg to 150 mg orally every 3 to 4 hours as
needed for to treat pain and discomfort;
maximum of 600 mg per day
(Parenteral)
- 50 to 150 mg IM or subcutaneously every 3 to
4 hours as needed; when multiple doses are
required, IM administration is recommended.
- Can be given intravenously, however lesser
doses are recommended and administration
should be done slowly, ideally with a diluted
solution.
(Patient Controlled Analgesia)
- Initial dose of 10 mg, with incremental doses
ranging from 1 to 5 mg; lockout interval of 6 to
10 minutes; dose adjustment dependent on
patient reaction
- 15 to 35 mg per hour usual dose for
 continuous IV infusion

For Pediatric patients

(Oral)
- Start treatment with DEMEROL Tablets or
Oral Solution in a dose range of 1.1 mg/kg to
1.8 mg/kg orally every 3 or 4 hours as needed,
up to the adult dose.
(Parenteral)
- Can be given intravenously, however lesser
doses are recommended and administration
should be done slowly, ideally with a diluted
solution.
Mode Of Action
Analgesia, euphoria, and sedation are produced by
acting as an agonist at certain opioid receptors in the
CNS; the receptors that mediate these actions are
assumed to be the same as those that mediate the
effects of endogenous opioids (enkephalins,
endorphins).

Indication -Acute pain relief from moderate to severe (oral,

parenteral)
-Preoperative medication, support of anesthesia, and
obstetric analgesia (parenteral)

Contraindication - Patients with hypersensitivity to narcotics, diarrhea

caused by poisoning, bronchial asthma, COPD, cor
pulmonale, respiratory depression, anoxia,
kyphoscoliosis, acute alcoholism, increased
intracranial pressure, pregnancy, seizure disorder,
renal dysfunction.
Side Effects - Dizziness, drowsiness, headache, nausea,
vomiting, sweating
Adverse Effects - Ureteral spasm, spasm of vesical sphincters,
urinary retention or hesitancy, oliguria, antidiuretic
effect, reduced libido or potency, respiratory
depression, apnea, circulatory depression,
respiratory arrest, shock, cardiac arrest

Drug Interaction 1. Barbiturate anesthetics potentiate effects;

reduce meperidine dose when co-
administering
2. When given to individuals who are receiving or
have recently received MAOIs, severe and
occasionally deadly responses (similar to
narcotic overdose; marked by convulsions,
hypertension, and hyperpyrexia) can occur
3. With phenothiazines, there is a higher chance
of respiratory depression, hypotension, deep
drowsiness, or coma.
4. Can lead to serious side effects such as
respiratory distress, coma, and even death
when taken together with medications that
could also cause central nervous system
depression

Nursing Responsibilities 1. Administer to lactating women 4-6 hours

before the next feeding
R: This is to minimize the amount in milk as
meperidine can pass into breastmilk and may
cause problems in a nursing baby
2. During parenteral delivery, keep a narcotic
antagonist on hand, as well as equipment for
assisted or controlled respiration
R: For immediate intervention if ever problem
occurs during administration

3. When injecting SC into chilled areas of the

body, especially in individuals with
hypotension or shock, proceed with caution.
R: When perfusion is compromised,
absorption may be delayed; when circulation
is restored, an excessive quantity may be
absorbed.

4. Reassure the patient about the dangers of

addiction.
R: Addiction, abuse, and misuse can lead to
overdose and death

5. Give a clear instruction and inform patients of

the risk of life-threatening respiratory
depression, including the fact that the risk is
highest when DEMEROL Tablets or Oral
Solution is first started or when the dosage is
increased, and that it can happen even at
approved levels.
R: For patients to be aware and to impart
knowledge as respiratory depression may be
one of the adverse effects of the drug

6. Use meperidine with great caution in patients

 with renal failure or those who require
repeated dosage.
R: Accumulation of normeperidine, which is a
toxic metabolite, can cause seizures

7. Patients taking phenothiazines or other

tranquilizers should reduce their meperidine
dosage by 25%–50%.
R: To avoid overdosage or any possible
problems or complications that may occur

8. Keep a record of how much medicine was

used from each new bottle and do not keep
leftover Demerol tablets.
R: A single dose of this drug might be fatal if
taken incorrectly or inadvertently.

9. Instruct patient to avoid alcohol, driving, or any

hazardous activity when taking the drug
R: When alcohol is mixed with meperidine,
dangerous adverse effects or death can
ensue; falls, accidents, and severe injuries
due to dizziness or drowsiness can happen if
without knowledge of how the medicine
affects.

10. Remind patients and caregivers that the drug

should be discarded as soon as it is no longer
needed.
R: Leaving DEMEROL Tablets and Oral
Solution unattended can pose a deadly risk to
 others in the home

11. Encourage patients not to stop taking

DEMEROL Tablets or Oral Solution without
first talking to their doctor about a tapering
plan
R: To avoid developing withdrawal symptoms

12. Instruct patients on how to determine

symptoms of low blood pressure and how to
avoid significant consequences if hypotension
occurs such as sitting or lying down, or
carefully rising from a sitting or lying position
R: This is due to reports that Demerol tablets
or Oral solution may cause orthostatic
hypotension and syncope

13. Inform female patients with the potential to get

pregnant that taking DEMEROL Tablets or
Oral Solution for an extended period of time
during pregnancy can result in neonatal opioid
withdrawal syndrome
R: Neonatal opioid withdrawal syndrome may
be life-threatening if failed to be recognized
and treated.

Bibliography:
Cunha, J. (2021). Demerol. Retrieved from: https://www.rxlist.com/demerol-
drug.htm#description
Nurse-sha.blogspot.com. (2009). Demerol drug study. Retrieved from: https://nurse-
sha.blogspot.com/2009/02/demerol-drug-study.html
Thornton, P. (2021). Demerol. Retrieved from: https://www.drugs.com/demerol.html