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Science (New York, N.Y.) Feb 1983Four persons developed marked parkinsonism after using an illicit drug intravenously. Analysis of the substance injected by two of these patients revealed primarily...
Four persons developed marked parkinsonism after using an illicit drug intravenously. Analysis of the substance injected by two of these patients revealed primarily 1-methyl-4-phenyl-1,2,5,6-tetrahydropyridine (MPTP) with trace amounts of 1-methyl-4-phenyl-4-propionoxy-piperidine (MPPP). On the basis of the striking parkinsonian features observed in our patients, and additional pathological data from one previously reported case, it is proposed that this chemical selectively damages cells in the substantia nigra.
Topics: Adult; Female; Humans; Male; Meperidine; Opioid-Related Disorders; Parkinson Disease, Secondary; Substantia Nigra
PubMed: 6823561
DOI: 10.1126/science.6823561 -
The Journal of Emergency Medicine 1995Meperidine is a synthetic opioid analgesic frequently prescribed in the emergency department. Meperidine is most often administered intramuscularly or intravenously, due... (Review)
Review
Meperidine is a synthetic opioid analgesic frequently prescribed in the emergency department. Meperidine is most often administered intramuscularly or intravenously, due to its poor oral bioavailability, and is metabolized extensively by the liver. Analgesic effects usually last 3-4 hours with parenteral administration, and some adverse effects such as nausea may be reduced when meperidine is combined with antiemetic or antihistaminic medications. Although meperidine is often a preferred analgesic by both patients and physicians in the treatment of disorders such as migraine headaches, its analgesic efficacy has rarely proven superior to alternative parenteral pain medications in controlled trials. In addition, meperidine can precipitate monoamine oxidase inhibitor reactions, and during metabolism it is demethylated to normeperidine, a compound with significant central nervous system (CNS) toxicity. Meperidine should be considered a second line agent in the treatment of pain when opioid analgesics are required.
Topics: Analgesics, Opioid; Humans; Meperidine
PubMed: 8747629
DOI: 10.1016/0736-4679(95)02002-0 -
The American Journal of Psychiatry Aug 1987Despite the widespread use of meperidine as an analgesic, its potential for producing delirium has been overlooked. Six cases demonstrating meperidine-induced behavioral...
Despite the widespread use of meperidine as an analgesic, its potential for producing delirium has been overlooked. Six cases demonstrating meperidine-induced behavioral toxicity are reported. Toxicity was more likely when meperidine was combined with cimetidine or drugs having anticholinergic activity. Discontinuation of meperidine and substitution of morphine for analgesia were usually successful in treating the delirium. Physostigmine reversed the delirium in one patient. The authors suggest that the delirium results from the excessive anticholinergic activity of meperidine or its only active metabolite, normeperidine.
Topics: Adult; Aged; Delirium; Drug Interactions; Drug Therapy, Combination; Female; Humans; Male; Meperidine; Middle Aged; Parasympatholytics
PubMed: 3605428
DOI: 10.1176/ajp.144.8.1062 -
Canadian Journal of Anaesthesia =... Nov 1999
Topics: Analgesics, Opioid; Anesthesia, Spinal; Humans; Injections, Spinal; Meperidine; Pain, Postoperative
PubMed: 10566938
DOI: 10.1007/BF03013216 -
Revista Espanola de Anestesiologia Y... Apr 2000Meperidine was the first synthetic opioid agent. It acts mainly as an antagonist of mu (#m) receptors and has an analgesic potency ten times greater than that of... (Review)
Review
Meperidine was the first synthetic opioid agent. It acts mainly as an antagonist of mu (#m) receptors and has an analgesic potency ten times greater than that of morphine. Like other opioid drugs, meperidine causes nausea, vomiting, urinary retention and respiratory depression; a point of difference, however, is that it acts on nerve fibers and has properties similar to those of local anesthetics. It has therefore been used as an alternative to other opioids for anesthetic blockade. We review the indications and contraindications of meperidine administered by different routes. For pain, epidural administration has proven to be a good alternative to intravenous administration and epidural meperidine has been combined with local anesthetics using lower doses of both drugs and producing fewer side effects. Intradural meperidine has been used as the sole anesthetic agent in various types of surgery, its principal advantage being that it provides long-lasting postoperative analgesia. Spinal meperidine has the advantage over morphine of a lower incidence of respiratory depression, particularly late-occurring depression. An intravenous route has been used for treating moderate to severe pain, for regional anesthesia, for premedication and for analgesia during anesthesia. Meperidine's action on kappa receptors has meant that it is considered the most effective drug for treating postanesthetic trembling. Although meperidine has been used effectively to treat non-surgical pain, mainly from colic, this review focuses on its usefulness in the perioperative period.
Topics: Adjuvants, Anesthesia; Anesthesia, Epidural; Anesthesia, Intravenous; Humans; Meperidine
PubMed: 10846914
DOI: No ID Found -
BMC Veterinary Research Oct 2020Meperidine is a synthetic opioid that belongs to the phenylpiperidine class and is a weak mu receptor agonist. In horses there are a limited number of published studies...
BACKGROUND
Meperidine is a synthetic opioid that belongs to the phenylpiperidine class and is a weak mu receptor agonist. In horses there are a limited number of published studies describing the analgesic effects of systemically administered meperidine in horses. The objective of this study was to describe the pharmacokinetics, behavioral and physiologic effects and effect on thermal threshold of three doses of intravenously administered meperidine to horses. Eight University owned horses (four mares and four geldings, aged 3-8 years were studied using a randomized balanced 4-way cross-over design. Horses received a single intravenous dose of saline, 0.25, 0.5 and 1.0 mg/kg meperidine. Blood was collected before administration and at various time points until 96 hours post administration. Plasma and urine samples were analyzed for meperidine and normeperidine by liquid chromatography-mass spectrometry and plasma pharmacokinetics determined. Behavioral and physiologic data (continuous heart rate, step counts, packed cell volume, total plasma protein and gastrointestinal sounds) were collected at baseline through 6 hours post administration. The effect of meperidine administration on thermal nociception was determined and thermal excursion calculated.
RESULTS
Meperidine was rapidly converted to the metabolite normeperidine. The volume of distribution at steady state and systemic clearance (mean ± SD) ranged from 0.829 ± 0.138-1.58 ± 0.280 L/kg and 18.0 ± 1.4-22.8 ± 3.60 mL/min/kg, respectively for 0.5-1.0 mg/kg doses. Adverse effects included increased dose-dependent central nervous excitation, heart rate and cutaneous reactions. Significant effects on thermal nociception were short lived (up to 45 minutes at 0.5 mg/kg and 15 minutes at 1.0 mg/kg).
CONCLUSIONS
Results of the current study do not support routine clinical use of IV meperidine at a dose of 1 mg/kg to horses. Administration of 0.5 mg/kg may provide short-term analgesia, however, the associated inconsistent and/or short-term adverse effects suggest that its use as a sole agent at this dose, at best, must be cautiously considered.
Topics: Administration, Intravenous; Analgesics, Opioid; Animals; Central Nervous System; Female; Heart Rate; Horses; Hot Temperature; Male; Meperidine; Nociception; Urticaria
PubMed: 32998730
DOI: 10.1186/s12917-020-02564-4 -
Anesthesia and Analgesia Mar 1982
Topics: Anaphylaxis; Antibody Specificity; Child, Preschool; Drug Hypersensitivity; Female; Humans; Immunoglobulin E; Meperidine; Radioallergosorbent Test
PubMed: 7199844
DOI: No ID Found -
Journal of Clinical Pharmacology 1978
Topics: Humans; Meperidine
PubMed: 624777
DOI: 10.1002/j.1552-4604.1978.tb02440.x -
Journal of Clinical Pharmacology Jan 1979
Topics: Biological Availability; Humans; Meperidine; Models, Biological
PubMed: 762255
DOI: 10.1002/j.1552-4604.1979.tb01622.x -
Gastrointestinal Endoscopy 1994Meperidine is routinely proscribed during sphincter of Oddi manometry because narcotics have been associated with spasm of the sphincter of Oddi. We have performed a...
Meperidine is routinely proscribed during sphincter of Oddi manometry because narcotics have been associated with spasm of the sphincter of Oddi. We have performed a prospective study of the effect of meperidine on sphincter of Oddi manometry in 18 patients undergoing manometry for suspected sphincter dysfunction. After diagnostic manometry using only intravenous diazepam sedation, the endoscope remained in the duodenum while 1 mg/kg intravenous meperidine was given. Five minutes later sphincter manometry was repeated. There was no difference in the baseline sphincter pressure before and after meperidine in all patients. The frequency of phasic contractions increased after meperidine (p = 0.001). Baseline sphincter pressure is generally the only manometric criteria used to diagnose sphincter dysfunction and this did not change after meperidine. We conclude that meperidine may be used for additional analgesia during sphincter manometry. This may improve patient tolerance and the success rate of this procedure.
Topics: Adult; Aged; Cholangiopancreatography, Endoscopic Retrograde; Female; Humans; Male; Manometry; Meperidine; Middle Aged; Patient Acceptance of Health Care; Prospective Studies; Sphincter of Oddi
PubMed: 8163140
DOI: 10.1016/s0016-5107(94)70002-8