What do you know about Meperidine?

Demerol is a synthetic opioid pain medication. It’s primarily used to treat moderate to severe pain, both acute and chronic. However, its use has become less common in recent years due to safety concerns and the availability of other, safer opioids like morphine or fentanyl.

Here are some key points about meperidine:

1. Mechanism of Action:

• Like other opioids, meperidine works by binding to opioid receptors in the brain and nervous system, reducing the perception of pain. It mainly acts on mu-opioid receptors.

2. Uses:

• Acute pain: Often used for post-surgical pain, injury-related pain, and labor pain.
• Chronic pain: Used less frequently for chronic conditions due to its side effects and risk of accumulation with long-term use.

3. Dosage and Administration:

• Demerol is available in oral and injectable forms.
• The dosing varies depending on the patient’s age, weight, medical condition, and response to treatment.

4. Side Effects:

• Common opioid side effects like drowsiness, dizziness, nausea, vomiting, constipation, and sweating.
• Respiratory depression: A serious risk, especially at higher doses.
• Seizures: Meperidine has a unique risk due to its metabolite, normeperidine, which can accumulate and cause seizures, particularly in patients with kidney dysfunction or those taking it for long periods.

5. Drug Interactions:

• Demerol should not be taken with MAO inhibitors (a type of antidepressant), as this combination can cause life-threatening reactions.
• It may also interact with other central nervous system depressants like alcohol, benzodiazepines, and other opioids.

6. Addiction and Tolerance:

• Demerol, like other opioids, has a high potential for abuse, addiction, and dependence.
• Long-term use can lead to tolerance, meaning higher doses are needed to achieve the same level of pain relief.

7. Alternatives:

• Due to its safety profile, meperidine is no longer a first-line opioid in most settings. Alternatives such as morphine, oxycodone, or fentanyl are often preferred.

Meperidine’s use has declined because of its higher risk profile compared to other opioids, particularly because of concerns over its toxic metabolite (normeperidine) and seizure risk.