Demerol is passe?? Can anyone fill me in? - page 3
by steel magnolia 20,894 Views | 23 Comments
Hi, not a pain specialist, but I have been hearing demerol being criticized as ineffective for pain relief a lot lately. Where is this research coming from? Is there a resource anyone can recomened for learning more about this?... Read More
- 0Aug 20, '08 by Spidey's mom GuideQuote from DaqueengeneWe had an in-service 10 years ago from a pain specialist about this and the recommendation was not to use it.Demerol has fallen out of favor in pain management due to the breakdown of demerol in the body produces nor-meperidine. With prolonged use as in chronic pain management this build up can cause dangerous and uncomfortable S/Es. As nor-meperidine builds up in the body it can cause confustion, combative behavior and can lower the seisure threshold. Demerol more specifically nor-meperidine is metabolised in the kidney thus anyone with kidney disease of dysfunction should not recieve it. Elderly people who are more prone to confusion (sun downers) ect should not recieve it. Demerol is fine for short lived acute pain in young healthy people although most Dr.s don't prescribe it correctly since in young healthy individuals with good kidney function will clear the drug quicker than the usual q 4 hrs it is prescribed Q2 to Q3 is more in line with the drugs bioavaliability. Demerol works well in post op especially for the patient who is having post operative shakes. Long term pain management is not the correct clinicle application of demerol. While I am on it Phenergan doesn't potentiate anything except sedation. Phenergan has been shown to actually increase pain perception in patients. We think we controll their pain we just knock them out with sedation and do nothing for their pain. FYI I learned most of this during a short stint as a hsopice nurse and through a chronic pain management seminar.