Demerol is passe?? Can anyone fill me in?Register Today!
- by steel magnolia Apr 23, '04Hi, 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?
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- Apr 23, '04 by TweetyI know one of the reasons that demerol has fallen out of favor is that it accumulates and can cause seizures. Don't have any references though.
- Apr 23, '04 by purplemaniathe elderly are particularly sensitive to having altered mental status when on Demerol. I believe the thinking is that since other drugs can effectively treat pain without psychotropic side effects, we should not use Demerol.
- Apr 23, '04 by RN-PANow that you mention it, I can't remember the last time I had a Demerol order for pain. It's generally been Morphine or Dilaudid that's being ordered on our med-surg unit.
- Apr 23, '04 by z's playaDemerol does exaserbate siezures and cause tremors after prolonged use however I feel Demerol is getting a bad rap overall because this the drug of choice for many so-called drugseekers but it is also very effective for migraines (when used as strictly pain control...not abortive agent) and other pain when combined with say Torodol or other nsaids. Its also a good second choice if one is allergic to morphine since Fentanyl is a short acting. (according to my pcp) That's my .02 cents.
AAARGH! Where's Dave when you need him?
- Apr 23, '04 by rollingstoneDemerol (meperidine) when metabolized produces noremeperidine which lowers the seizure threshhold. Lately I've used small (25mg) IVP doses in patients to control shivering.
- Apr 23, '04 by nurse_robinQuote from rollingstoneYeah, there's usually an order for Demerol for fresh post-op pts during recovery for shivering.Demerol (meperidine) when metabolized produces noremeperidine which lowers the seizure threshhold. Lately I've used small (25mg) IVP doses in patients to control shivering.
- Apr 23, '04 by PalpitationsWhen I was fresh post-op for a thyroidectomy, I remember being in #10 pain when I awoke. I asked the nurse "What did you give me, Narcan?". She said "I have given you a 100 mgs. of Demerol!" I told her that Demerol didn't kill my pain. She called the doctor, got the order for morphine and that did the job. Also, Toradol works better for me then Demerol.
Demerol can be a cerebral irritant esp. in certain patient populations.
Quote from nurse_robinYeah, there's usually an order for Demerol for fresh post-op pts during recovery for shivering.
- Apr 25, '04 by IMustBeCrazyA bit off track but a question...
Demerol (meperidine) when metabolized produces noremeperidine which lowers the seizure threshhold. Lately I've used small (25mg) IVP doses in patients to control shivering.
- Apr 25, '04 by sharannIMUSTBECRAZY, you ask a good question. Shivering post-op actually leads to heat loss, increased risk for cardiac arrythmias, and increased pain. After surgery, one of our key goals is to maintain core and surface body temps. If a patient is hypothermic they are at risk for more post-op complications including taking the oxygen away from cells(shivering uses oxygen) and acidosis.