whilst really serious, life-threatening, or lethal respiratory despair can come about Anytime in the course of the use of DEMEROL Injection, the risk is finest in the initiation of therapy or pursuing a dosage boost.
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Because aged people are more likely to have diminished renal operate, care needs to be taken in dose variety, and it may be valuable to observe renal function.
as the duration of opioid reversal is predicted to generally be under the length of motion of meperidine in DEMEROL Injection, carefully check the affected individual until finally spontaneous respiration is reliably re-proven.
If the choice is made to prescribe a benzodiazepine or other CNS depressant concomitantly using an opioid analgesic, prescribe the lowest effective dosages and least durations of concomitant use. In individuals already getting an opioid analgesic, prescribe a decreased Original dose from the benzodiazepine or other CNS depressant than indicated from the absence of the opioid, and titrate determined by medical response.
The concomitant use of DEMEROL Injection with all cytochrome P450 3A4 inhibitors may perhaps lead to a rise in meperidine plasma concentrations, which could improve or extend adverse reactions and could cause potentially lethal respiratory melancholy.
Meperidine causes miosis, even in complete darkness. Pinpoint pupils are a sign of opioid overdose check here but will not be pathognomonic (e.g., pontine lesions of hemorrhagic or ischemic origins may possibly make equivalent results). Marked mydriasis rather then miosis may very well be seen as a result of hypoxia in overdose conditions.
tend not to use DEMEROL Injection in people using MAOIs or inside of fourteen days of halting this kind of procedure. Intravenous hydrocortisone or prednisolone are already utilized to deal with serious reactions, With all the addition of intravenous chlorpromazine in All those circumstances exhibiting hypertension and hyperpyrexia. The usefulness and safety of narcotic antagonists in the remedy of such reactions is unfamiliar.
evaluate Each and every affected individual's risk for opioid dependancy, abuse, or misuse before prescribing DEMEROL Injection, and keep track of all individuals getting DEMEROL Injection for the event of such behaviors and situations. Risks are elevated in sufferers with a private or family members record of material abuse (which include drug or alcohol abuse or dependancy) or mental illness (e.
Meperidine causes a reduction in motility affiliated with a rise in sleek muscle mass tone in the antrum of your tummy duodenum. Digestion of meals within the modest intestine is delayed and propulsive contractions are reduced.
both of those tolerance and Actual physical dependence can establish during usage of opioid therapy. Tolerance can be a physiological condition characterised by a decreased response to your drug right after repeated administration (i.
five)]. just after halting a CYP3A4 or CYP2B6 inducer, because the effects of the inducer drop, the meperidine plasma focus will maximize [see Clinical Pharmacology (twelve.three)], which could enhance or lengthen the two the therapeutic effects and adverse reactions and could cause significant respiratory depression.
Dosage ought to be modified according to the severity in the ache as well as the response with the patient. While subcutaneous administration is appropriate for occasional use, intramuscular administration is most well-liked when repeated doses are needed.
Abuse of and dependancy to opioids in a few folks is probably not accompanied by concurrent tolerance and indicators of Bodily dependence. In addition, abuse of opioids can occur during the absence of dependancy.