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JAMA Jan 1975
Topics: Accidents, Home; Adult; Animals; Bites and Stings; Female; Fishes, Poisonous; Humans; Injections, Intramuscular; Meperidine
PubMed: 1172685
DOI: No ID Found -
Journal of Clinical Pharmacology Apr 1978Of 26,294 hospitalized medical patients monitored in a drug surveillance program, 366 (1.4%) received meperidine orally and 3268 (12.4%) received meperidine parenterally...
Of 26,294 hospitalized medical patients monitored in a drug surveillance program, 366 (1.4%) received meperidine orally and 3268 (12.4%) received meperidine parenterally during one or more admissions. Neoplastic disease was the most common category of primary diagnosis (43%) among oral recipients; among parenteral recipients cardiovascular and neoplastic diseases (23% each) were most common. Oral meperidine was prescribed almost exclusively (93%) for pain relief, whereas the parenteral drug also had substantial use (41%) as a diagnostic and preoperative adjunct. Oral meperidine was judged by attending physicians to have provided unsatisfactory pain relief in 22% of recipients, while parenteral meperidine was rated unsatisfactory in 11%. The drug was less effective in patients with a primary diagnosis of neoplastic disease than in patients with other primary diagnoses. Minor gastrointestinal disturbances were the most commonly reported adverse reactions among oral meperidine recipients (2.7%); among parenteral recipients central nervous system effects were most common (1.2%). Seven recipients had life-threatening adverse reactions. However, only two of these were judged definitely related to meperidine, and in both instances other drugs were also definitely implicated. Adverse reactions were dose related.
Topics: Administration, Oral; Drug Evaluation; Humans; Infusions, Parenteral; Meperidine; Middle Aged
PubMed: 632364
DOI: 10.1002/j.1552-4604.1978.tb01591.x -
American Journal of Obstetrics and... Feb 1985It has been suggested that continued diffusion gradients from mother to fetus would exist and that both meperidine and normeperidine would accumulate in the fetus...
It has been suggested that continued diffusion gradients from mother to fetus would exist and that both meperidine and normeperidine would accumulate in the fetus following multiple doses of meperidine to the mother during labor. However, no pharmacokinetic data are available. Therefore, the purpose of this study was to document the disposition of meperidine and normeperidine in the fetus and neonate following multiple doses of meperidine to the mother over long time periods. Twelve infants were studied. The results show surprisingly high concentrations of both meperidine and normeperidine in fetal blood at delivery. In addition, the amount of normeperidine increased with time in umbilical cord blood, the ratio of normeperidine to meperidine increased with time, and the umbilical artery-to-vein ratio of meperidine (but not normeperidine) was greater than one following long drug-to-delivery intervals. The data also suggest that with long drug-to-delivery intervals the levels of normeperidine may become clinically important and that the elimination of both compounds by the neonate is prolonged. The study suggests that multiple doses to the mother over long time periods result in maximum accumulation of both meperidine and normeperidine in fetal tissues.
Topics: Female; Fetal Blood; Fetus; Humans; Infant, Newborn; Kinetics; Labor, Obstetric; Maternal-Fetal Exchange; Meperidine; Pregnancy
PubMed: 3970110
DOI: 10.1016/0002-9378(85)90314-x -
Anesthesia and Analgesia Mar 1985After meperidine administration during labor, meperidine reaches its highest level in fetal tissues within 2-3 hr. The highest levels of normeperidine, the active...
After meperidine administration during labor, meperidine reaches its highest level in fetal tissues within 2-3 hr. The highest levels of normeperidine, the active metabolite of meperidine, are, on the other hand, determined in fetal tissues by the time between administration of meperidine to the mother and delivery: the greater the drug-to-delivery interval (DDI), the higher the fetal levels of normeperidine. Because of the different times to peak fetal levels of meperidine and normeperidine, it may be possible to partially separate the effects of meperidine and its metabolite on the neonate using the DDI. The purpose of this study was to determine whether low doses of meperidine affected performance on the Brazelton Neonatal Behavioral Assessment Scale (BNBAS), and whether this performance is related to the DDI or to levels of meperidine or to normeperidine. Sixteen control neonates whose mothers received no meperidine and 41 study infants whose mothers received 25-100 mg meperidine intravenously (mean 39 +/- 19 mg) were studied. Comparisons of BNBAS scores of control and study infants measured at less than 12 hr, again at 3 days of age, and the effect of DDI were made using repeated measures analyses of variance (ANOVA). Correlation techniques were used to examine relationships between BNBAS performance and clinical and pharmacological variables related to drug administration. The BNBAS cluster scores representing regulation of state and number of abnormal reflexes were significantly different in study neonates from control neonates. Performance depended upon test day. Further analysis showed that longer DDIs resulted in less optimal BNBAS performance.(ABSTRACT TRUNCATED AT 250 WORDS)
Topics: Adult; Anesthesia, Obstetrical; Child Behavior; Female; Fetal Blood; Humans; Infant, Newborn; Meperidine; Pregnancy; Reflex; Time Factors
PubMed: 3977093
DOI: No ID Found -
American Journal of Hospital Pharmacy Jun 1975
Topics: Humans; Meperidine
PubMed: 1155465
DOI: No ID Found -
American Journal of Obstetrics and... Oct 2004This study was undertaken to evaluate whether the administration of meperidine decreases the length of labor in patients with a diagnosis of dystocia during the first... (Clinical Trial)
Clinical Trial Randomized Controlled Trial
OBJECTIVE
This study was undertaken to evaluate whether the administration of meperidine decreases the length of labor in patients with a diagnosis of dystocia during the first stage of labor.
STUDY DESIGN
Women with term singleton pregnancies who received a diagnosis of dystocia and required an active management of labor were randomly assigned to receive either 100 mg of meperidine or placebo. The primary outcome measure was length of labor.
RESULTS
Four hundred seven pregnant women were included. There were no significant statistical differences between meperidine and placebo groups in length of labor and operative delivery rates such as forceps and cesarean section by intention-to-treat analysis. Low Apgar scores, umbilical artery acidosis, and admission to neonatal care units were increased in the meperidine group.
CONCLUSION
Because of the absence of any benefits in patients with dystocia in labor and the presence of harmful effects on neonatal outcomes, meperidine should not be used during labor for this specific indication.
Topics: Analgesics, Opioid; Dystocia; Female; Humans; Labor Stage, First; Meperidine; Pain Measurement; Pregnancy; Time Factors; Uterine Contraction
PubMed: 15507943
DOI: 10.1016/j.ajog.2004.03.017 -
American Journal of Obstetrics and... Apr 1979The time interval between the administration of meperidine to laboring patients and delivery may affect neonatal status, but sophisticated analytic techniques have not...
The time interval between the administration of meperidine to laboring patients and delivery may affect neonatal status, but sophisticated analytic techniques have not been used to determine the exposure of the fetus to meperidine at various drug-delivery intervals. By means of gas chromatography and mass spectrometry, the concentrations of meperidine and normeperidine (the principle metabolite of meperidine) were quantitated in the umbilical cord venous and arterial plasma at delivery and in the urine of the neonate for three days postpartum. Following 50 mg. of meperidine administered intravenously during labor, fetal exposure to meperidine was highest two to three hours after maternal medication while fetal exposure to normeperidine was highest four hours or more after medication. We conclude from this study that there is a definite but nonlinear relationship between the drug-delivery interval and the amount of meperidine and normeperidine an infant receives; and that the drug-delivery intervals resulting in maximum fetal exposure reported here correspond with those resulting in maximum neonatal depression reported by others.
Topics: Chromatography, Gas; Delivery, Obstetric; Female; Fetal Blood; Fetus; Humans; Infant, Newborn; Labor, Obstetric; Male; Mass Spectrometry; Maternal-Fetal Exchange; Meperidine; Pregnancy; Time Factors; Umbilical Arteries; Umbilical Cord; Umbilical Veins
PubMed: 434035
DOI: 10.1016/0002-9378(79)90311-9 -
JAMA Apr 1988
Topics: Analgesia; Equipment Failure; Female; Humans; Meperidine; Middle Aged; Self Administration
PubMed: 3352117
DOI: No ID Found -
Lippincott's Case Management : Managing... 2004
Topics: Analgesics, Opioid; Humans; Meperidine; Pain
PubMed: 15540079
DOI: 10.1097/00129234-200409000-00008 -
Nursing Jan 2010
Topics: Analgesics, Opioid; Humans; Meperidine; Pain
PubMed: 20016334
DOI: 10.1097/01.NURSE.0000365924.16631.a4