Brand Name: Demerol
Percutaneous in-situ coronary venous arterialization is a new less invasive alternative to CABG.
Pregnancy Category B
Narcotic agonist analgesic
Mechanism of action of Demerol
Acts as agonist at specific opioid receptors in the CNS to produce analgesia, euphoria, sedation; the receptors mediating these effects are thought to be the same as those mediating the effects of endogenous opioids (enkephalins, endorphins).
Indications of Demerol
- Relief of moderate to severe pain (oral, parenteral)
- Preoperative medication, support of anesthesia, and obstetric
Contraindications of Demerol
- Presence of hypersensitivity to narcotics,
- Diarrhea caused by poisoning (before toxins are eliminated)
- Bronchial asthma, COPD, cor pulmonale, respiratory depression, anoxia
- Acute alcoholism
- Increased intracranial pressure
Use caution in the presence of acute abdominal conditions, cardiovascular disease, supraventricular tachycardias, myxedema, convulsive disorders, delirium tremens, cerebral arteriosclerosis, ulcerative colitis, fever, Addison's disease, prostatic hypertrophy, urethral stricture, recent GI or GU surgery, toxic psychosis, labor or delivery (administration of narcotics, including meperidine, to the mother can cause respiratory depression of neonate; premature infants are especially at risk), renal or hepatic dysfunction.
Adverse effects of Demerol
May produce less intense smooth muscle spasm, less constipation, less cough reflex suppression than equianalgesic doses of morphine.
- CNS: Lightheadedness, dizziness, sedation, euphoria, dysphoria, delirium, insomnia, agitation, anxiety, fear, hallucinations, disorientation, drowsiness, lethargy, impaired mental and physical performance, coma, mood changes, weakness, headache, tremor, convulsions, miosis, visual disturbances, suppression of cough reflex
- GI: Nausea, vomiting, dry mouth, anorexia, constipation, biliary tract spasm, increased colonic motility in patients with chronic ulcerative colitis
- CV: Facial flushing, peripheral circulatory collapse, tachycardia, bradycardia, arrhythmia, palpitations, chest wall rigidity, hypertension, hypotension, orthostatic hypotension, syncope
- GU: Ureteral spasm, spasm of vesical sphincters, urinary retention or hesitancy, oliguria, antidiuretic effect, reduced libido or potency
- Dermatologic: Pruritus,
urticaria, laryngospasm, bronchospasm, edema
Local: tissue irritation and induration (SC injection)
- Major hazards: Respiratory depression, apnea, circulatory depression, respiratory arrest, shock, cardiac arrest
- Other: Sweating, physical tolerance and dependence, psychological dependence
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