an appropriate pre-op medication

[GingerSue]

is demerol an appropriate pre-op medicaton (or post-op analgesic) for someone who has a malfunctioning kidney?

Without knowing the functioning of the other kidney - demerol is metabolized to normeperidine which is dependent on the kidneys for excretion.

(and normeperidine accumulates, seizures can result)

Is demerol appropriate?

[GingerSue]

thanks for the information

when I took pharmacology recently, my textbook says that meperidine use has greatly declined, now it is recommended for short-term use in healthy individuals, and is contraindicated for treatment of cancer pains. And that normeperidine accumulates with chronic use, large doses, or renal failure. (effects of normeperidine are not reversible with opioid antagonist drugs).

[TazziRN, RN]

You're asking about using demerol pre- and post left nephrectomy. There is no renal failure involved because the other kidney, presumably healthy since it's being left in, has already taken over the work of the diseased one. Yes, it accumulates and yes, its use has declined, but given the criteria you stated in your first post (use in a nephrectomy pt), it is not an inappropriate drug.