No More Demerol IV Push??? - page 4

In our school's teaching hospital, Demerol can no longer be given IV push (only IM). Is this a new trend? Has anyone heard of this? The rationale is that the metabolic breakdown product of meperidine... Read More

  1. Visit  cabgrn2 profile page
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    Quote from VickyRN
    In our school's teaching hospital, Demerol can no longer be given IV push (only IM). Is this a new trend? Has anyone heard of this? The rationale is that the metabolic breakdown product of meperidine (normeperidine) is neurotoxic and can cause agitation, irritability, nervousness, tremors, muscle twitching, myoclonus and seizures.

    http://ruralnet.marshall.edu/pain/demerol.htm
    http://www.hospicecares.org/Pharmacy...02Pharmacy.htm
    Vicky,
    Demerol will break down the same way whether it is IV or IM. Demerol is not the drug of choice for the reasons you mentioned as well as - why inflict pain (IM injection ) to relieve pain when there are so many other choices. We still have some MD's that order it and if we can't get them to change the order to a different pain med the patient gets it.
    LK
  2. Visit  NewERLPN profile page
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    We give Demerol IV like it is going out of style. Good to know.
  3. Visit  Mississippi_RN profile page
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    LOL... At our hospital, too. In fact, most every patient that comes in with anything related to pain gets Demerol... if not IV push, then IM. However, if they happen to have an IV, then they want it IV push. All our SC patients get it frequently. Never seen any neuro problems, though. I mentioned something to one of our doctors the other day about this discussion thread about some hospitals not giving it IV, or at all, anymore. He thought that was interesting...
  4. Visit  Katnip profile page
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    We still give IV demerol in the ED. Ours is the only pyxis that contains demerol, though. The floors aren't allowed to use it except for pt allergies, and then they have to request it from pharmacy.
  5. Visit  teeituptom profile page
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    We still use demerol also. But my thought is what is going to happen to all those poor little frequent flyers who come saying they can only take demerol. That must be such a dissapointment for them. I feel so sorry for them.
  6. Visit  ladylynx profile page
    0
    Quote from VickyRN
    In our school's teaching hospital, Demerol can no longer be given IV push (only IM). Is this a new trend? Has anyone heard of this? The rationale is that the metabolic breakdown product of meperidine (normeperidine) is neurotoxic and can cause agitation, irritability, nervousness, tremors, muscle twitching, myoclonus and seizures.

    http://ruralnet.marshall.edu/pain/demerol.htm
    http://www.hospicecares.org/Pharmacy...02Pharmacy.htm
    In Florida, they basically did away with Demerol. There was literature passed around and for the central Florida area, the only exceptions were in PACU and OR. They posted charts that gave alternatives and comparable dosages.

    What I found most interesting is that Dilaudid 2mg is equal to Morphine 10mg. Now that I am in Georgia, they are scared to give Morphine 4 mg, or even Dilaudid at all. Among many other issues, they were clueless to the debate on Demerol (4 of the hospitals thus far).

    Coming from Tennessee, I found that the days of giving Demerol 100mg every 4 hours, Dilaudid 2mg every 4 hours, and Morphine 5-10mg, we got the patients up and out faster. Making sure we weaned them by the night before discharge.

    Peace and love...nothing less! The Lady
  7. Visit  NRSKarenRN profile page
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    If Dilaudid not in stock, what drug do you give for rigors associated with IV Vancomycin?
  8. Visit  ladylynx profile page
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    Quote from NRSKarenRN
    If Dilaudid not in stock, what drug do you give for rigors associated with IV Vancomycin?
    I've never worked at a hospital thus far that Dilaudid was not in stock. Out of 15 years I have only seen 1 reaction from Vancomycin that required a medication atagonist. With C-Diff on the rise, we are using Vancomycin like it is the new Penicillin.
  9. Visit  CritterLover profile page
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    Quote from ladylynx
    i've never worked at a hospital thus far that dilaudid was not in stock. out of 15 years i have only seen 1 reaction from vancomycin that required a medication atagonist. with c-diff on the rise, we are using vancomycin like it is the new penicillin.
    i think she may be referring to the current nation-wide shortage of dilaudid.
  10. Visit  Spidey's mom profile page
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    About 6 years ago we had a physician give a conference regarding Demerol being phased out . . . .never happened here.

    We give it IV all the time.

    steph
  11. Visit  teeituptom profile page
    1
    Quote from critterlover
    i think she may be referring to the current nation-wide shortage of dilaudid.

    the way the doctors in my er order no wonder there is a shortage.

    ingrown toenail, dilaudid 2 ivp

    subungal hematoma, dilaudid 2 ivp

    runny nose,,dilaudid 2 ivp
    DeLanaHarvickWannabe likes this.
  12. Visit  Spidey's mom profile page
    0
    Quote from teeituptom
    The way the doctors in my ER order no wonder there is a shortage.

    Ingrown toenail, dilaudid 2 IVP

    Subungal hematoma, dilaudid 2 IVP

    Runny nose,,dilaudid 2 IVP



    steph
  13. Visit  sharann profile page
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    Every drug has its adverse effects and it is not helpful to deem a drug evil when each case is different. In the area I work(PACU) Demerol is used for shivering and pain. Is it a first choice for pain? Not always. Have you ever had a patient with Fentanyl get rigid chest syndrome? Scary stuff. Phenergan is worse than Demerol in my opinion due to the many EPS side effects.
    One poster said Demerol made her crazy and therefore it should be banned. Well, Morphine has made many of my patients crazy, but I would keep it around.
    Nursing is about evidence based practice and sometimes we need to use the real life experiences of nurses who actually see the effects on REAL patients rather than just blindly listening to ONE research study(possible funded by a competing drug company?)and making rash decisions.It would be a real shame if a medication that has valid uses was banned because of what it might do. Look at Vioxx. How many people are in debilitating pain again because Vioxx MAY cause them heart problems(or may not)


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