Demerol is passe?? Can anyone fill me in?

Tweety, BSN, RN · Apr 23, 2004

I 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.

purplemania, BSN, RN · Apr 23, 2004

the 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.

RN-PA, RN · Apr 23, 2004

Now 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.

z's playa · Apr 23, 2004

Demerol 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?

rollingstone · Apr 23, 2004

Demerol (meperidine) when metabolized produces noremeperidine which lowers the seizure threshhold. Lately I've used small (25mg) IVP doses in patients to control shivering.

nurse_robin · Apr 23, 2004

Demerol (meperidine) when metabolized produces noremeperidine which lowers the seizure threshhold. Lately I've used small (25mg) IVP doses in patients to control shivering.

Yeah, there's usually an order for Demerol for fresh post-op pts during recovery for shivering.

Palpitations · Apr 23, 2004

When 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.

http://www3.us.elsevierhealth.com/WOW/op024.html

Yeah, there's usually an order for Demerol for fresh post-op pts during recovery for shivering.

IMustBeCrazy · Apr 25, 2004

A 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.

In what circumstance would you want to control shivering post op? I was taught shivering is a normal and necessary physiologic response resulting from being in a cool OR?

IMustBeCrazy · Apr 25, 2004

A 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.

In what circumstance would you want to control shivering post op? I was taught shivering is a normal and necessary physiologic response resulting from being in a cool OR?

sharann, BSN, RN · Apr 26, 2004

IMUSTBECRAZY, 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.

Gldngrl · Apr 26, 2004

Also seen Demerol given (25mg) IV for rigours with Albecet. (Premedicated as well w/ Benedryl/Tylenol).