Induction Meds: Opioids Agonist - Meperidine

Question 1

What receptors does Meperidine agonize?

Answer 1

• μ and κ receptors
• α2 receptors as well

S31

Question 2

What are the analogues of meperidine?
What other drugs does meperidine have a similar organic structure to?

Answer 2

-Analogues: Fentanyl & it’s derivatives

• structure similarity: Lidocaine & Atropine

S31

Question 3

How potent is Meperidine?
How long does it last?

Answer 3

• 10% as potent as morphine
• Duration: 2-4 hours

S32

Question 4

What is the dose and primary indication for Meperidine?

Answer 4

12.5 mg IV for Post-operative shivering

S32/33

Question 5

When should Meperidine not be used?

Answer 5

• Bronchoscopies (promotes coughing)
• diarrhea
• cough suppressant

S33

Question 6

What are the effects of Meperidine?

Answer 6

• sedation
• euphoria
• N/V
• depression of ventilation

S32

Question 7

What is the metabolism and how much is protein bound of Meperidine?

Answer 7

90 % hepatic metabolism
–> Normeperidine

60 % protein bound (consider with elderly)

S32

Question 8

What is the elimination profile of Meperidine?

Answer 8

Elimination: Renal (acidic urine can speed elimination)

Elimination 1/2 time: 3 to 5 hours (35 hours with renal failure)

S32

Question 9

What are the toxic effecs of Meperidine?

Answer 9

• delirium (confusion, hallucinations)
• myoclonus
• seizures

S32

Question 10

What are the side effects of Meperidine?

Answer 10

• tachycardia
• mydriasis with dry mouth
• (-) inotropy
• serotonin syndrome (MAOIs & TCAs)
• impaired ventilation
• crosses placenta

Question 11

True or False: Meperidine develops withdrawal symptoms more rapidly than Morphine?

Answer 11

True

S33