Demerol

Demerol is a narcotic pain reliever used to treat moderate to severe pains. It works by numbing the pain perception area in the brain. It can also be used prior to, or during surgical procedures.

682 Questions
Medication and Drugs
Hydrocodone
Oxycodone
Painkillers
Demerol

Is Demerol stronger than hydrocodone?

yes

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Medication and Drugs
Hydrocodone
Painkillers
Demerol

Can you take Lortab and Demerol together?

Can you take lortab and demerol together?

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Medication and Drugs
Oxycodone
Painkillers
Demerol

What is stronger Demerol or oxycodone?

From experience if you take the same amount of oxycodone(ex. percocet roxicodone) and demerol, Demerol is stronger.

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Medication and Drugs
Depakote
Morphine
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Demerol

What are the pharmacokinetics of Demerol?

2.0 Pharmacokinetics

Onset and Duration

Drug Concentration Levels

ADME 2.1 Onset and Duration

A) Onset 1) Initial Response a) Analgesia, subcutaneous: 10 minutes (Gilman et al, 1985). 1) Analgesia, intramuscular: 10 minutes (Gilman et al, 1985).

2) Analgesia, epidural: 5 to 30 minutes (Glynn et al, 1981). 2) Peak Response a) Analgesia, intramuscular: 30 to 50 (AMA Department of Drugs, 1986b). B) Duration 1) Single Dose a) Analgesia, subcutaneous: 2 to 4 hours (Gilman et al, 1985; AMA Department of Drugs, 1986b). 1) Analgesia, intramuscular: 2 to 4 hours (Gilman et al, 1985; AMA Department of Drugs, 1986b).

2) Anesthesia, intrathecal: 77 minutes (sensory block); 47 minutes (motor block) (Naguib et al, 1986).

3) Analgesia, epidural: 6 to 8 hours (Glynn et al, 1981).

2.2 Drug Concentration Levels

A) Therapeutic Drug Concentration 1) Analgesia, not well established a) The apparent minimally effective level for analgesia in most patients has been reported to be 0.2 mcg/mL one hour following an INTRAMUSCULAR dose of 1 mg/kg (Shih et al, 1976).

b) Blood concentrations of 0.7 mcg/mL maintained by an INTRAVENOUS infusion provided relief from severe pain in 95% of the cases studied (Austin et al, 1980).

c) Mean minimally effective plasma levels were lower with patient controlled analgesia (296 ng/mL) than with 100 mg intramuscular injections given every 3 to 4 hours (551 ng/mL) when studied in a small series of 10 post-surgical patients (Baumann et al, 1991).

d) Lower mean plasma levels of meperidine were found in patients using patient-controlled epidural analgesia than in patients using PCA delivered intravenously (Paech et al, 1994a). In a double-blind, crossover study of post-Cesarian patients, plasma levels during EPIDURAL administration were about one-half that of the period during which patients received INTRAVENOUS patient controlled analgesia meperidine. B) Time to Peak Concentration 1) Intramuscular, 25 minutes (Boreus et al, 1983). a) Mean maximal plasma levels of 200 to 230 ng/mL were reached within 25 minutes after 100 mg meperidine intramuscular, persisting for 120 minutes (Boreus et al, 1983). From Micromedex 2.3 ADME

Absorption Distribution Metabolism Excretion Elimination Half-life

2.3.1 Absorption

A) Bioavailability 1) Absorption following ORAL administration varies (Mather et al, 1975a; Stambaugh, 1976; Burn, 1955). a) Well absorbed following PARENTERAL administration (Mather et al, 1975a; Stambaugh, 1976; Burn, 1955).

b) Entry of normeperidine into systemic circulation is rapid and depends on the rate of absorption and first-pass metabolism of meperidine rather than the rate of elimination of drug or metabolite. Oral doses of meperidine generate greater amounts of normeperidine than equianalgesic intravenous doses (Pond & Kretschzmar, 1981b). 2) Intramuscular, injection: 57% (Jacobsen et al, 1988). a) Within 240 minutes following doses of 1 mg/kg in children (Jacobsen et al, 1988). 3) Intranasal: 78% (Striebel et al, 1993).

2.3.2 Distribution

A) Distribution Sites 1) Protein Binding a) 65% to 80% (Bennett et al, 1987). 1) Alpha-1 acid glycoprotein (AAG) and albumin are the major binding proteins of meperidine. In vitro, percent binding to albumin is relatively independent of either meperidine or albumin concentrations, ranging from approximately 16% to 21%. However, binding to AAG is AAG-concentration dependent. At normal AAG levels (50 to 100 mg/dL), percent of meperidine binding was 32% to 46%. When AAG levels increase (as in stress) to 200 to 300 mg/dL, meperidine binding also increases to 55% to 66%. In vivo, this increased meperidine binding may be interpreted as apparent tolerance (Julius et al, 1989). a) In the elderly, MEPERIDINE is less protein bound; however, the clearance rate is unchanged. This suggests that the volume of distribution may be greater with more available free drug (Wallace & Watanabe, 1977). 2) OTHER DISTRIBUTION SITES a) CEREBROSPINAL FLUID (CSF) (Boreus et al, 1983). 1) Following 100 mg intramuscular meperidine (equivalent to 87 mg base), parent compound was detected in CSF within 18 minutes (25 ng/mL), reaching a plateau within 90 minutes. The normeperidine metabolite was not detectable before 90 minutes. Serum/CSF concentration ratios for both the parent and metabolite were 0.46 and 0.42, respectively, at 240 minutes (Boreus et al, 1983). Following 1 mg/kg intrathecal dosing, CSF:plasma ratio was found to be 0.38 at 16 hours (Maurette et al, 1989). 3) PLACENTA (Rayburn et al, 1989a; Savona-Ventura et al, 1991) a) Feto-maternal plasma concentrations ratios have been reported to range from 0.35 to 3.5 (Tomson et al, 1982; Husemeyer et al, 1982a) with mean ratios of 0.63 to 0.65 (Rayburn et al, 1989a; Savona-Ventura et al, 1991) which reached maximums of 0.95 at 3 to 4 hours after maternal dosing. B) Distribution Kinetics 1) Distribution Half-Life a) 4.2 minutes (Klotz et al, 1974). 1) Distribution (alpha) half-life was reported to be 0.19 hours in both normal and cirrhotic patients (Klotz et al, 1974). a) In pregnant patients, intramuscular, intravenous, or epidural doses were associated with distribution half-lives between 7.3 and 8.3 minutes (Husemeyer et al, 1982a). 2) Volume of Distribution a) 3.1 to 5 L/kg (Bennett et al, 1987; Persson et al, 1988).

2.3.3 Metabolism

A) Metabolism Sites and Kinetics 1) LIVER (AMA, 1986). a) Meperidine, when given orally, is 50% metabolized in the first pass through the liver (AMA Department of Drugs, 1986b). 1) Any enhancement of meperidine metabolism to normeperidine may be associated with reduced analgesic efficacy and greater potential for normeperidine toxicity (Pond & Kretschzmar, 1981b). B) Metabolites 1) Normeperidine (active) (Anderson et al, 1976).

2) Normeperidinic acid (active) (Anderson et al, 1976).

3) Meperidinic acid (active) (Anderson et al, 1976). a) Meperidine is demethylated to form normeperidine, which is then hydrolyzed along with meperidine to normeperidinic acid and meperidinic acid. The acid metabolites are less active than meperidine and are further metabolized through conjugation (Anderson et al, 1976).

b) Meperidine use in newborns was studied, and normeperidine formation was reported to be slower in this age group (Pokela et al, 1992a).

2.3.4 Excretion

A) Kidney 1) Renal Excretion (%) a) 0.5% to 5.2% (average 2.2%) unchanged (Klotz et al, 1974). 2) The active metabolite, normeperidine, is reported to be excreted 0.6% to 21% (average 6.2%) unchanged in the urine (Klotz et al, 1974).

3) Fifty-three percent of the total metabolites are excreted in the urine in the 24-hour period following administration (Anderson et al, 1976).

4) The cumulative urinary excretion of normeperidine over 24 hours was significantly lower in geriatric patients than in young patients (Odar-Cederlof et al, 1985). In geriatric patients only 2.7% was excreted compared to 7.1% in young patients.

5) A study of Caucasian, Nepalese, and Chinese surgical patients failed to show differences in the proportional excretion of metabolites (Houghton et al, 1993). B) Other 1) OTHER EXCRETION a) Higher concentrations in the saliva than in the blood have been reported after intramuscular administration. Levels vary two- to seven-fold (Freeborn et al, 1980).

2.3.5 Elimination Half-life

A) Parent Compound 1) ELIMINATION HALF-LIFE a) 3.2 to 3.7 hours (Klotz et al, 1974; McHorse et al, 1975; Mather et al, 1975a). 1) Acute viral hepatitis is reported to prolong half-life (McHorse et al, 1975). In cirrhosis, beta half-life increased to 7.0 hours (Klotz et al, 1974).

2) In the elderly, meperidine has a greater half-life (Wallace & Watanabe, 1977).

3) In the neonate, the half-life of MEPERIDINE has been variously reported as 7 to 40 hours (Kuhnert et al, 1985a), or 4.9 to 16.8 hrs (Poleka et al, 1992), in term infants less than one week of age.

4) In pregnant patients terminal half-lives were shorter for either intravenous or epidural dosing (157 to 188 minutes) compared to intramuscular (227 minutes) with data collected over 2 hours only. Following epidural dosing in non-pregnant volunteers, the terminal half-life was 286 minutes (Husemeyer et al, 1982a). B) Metabolites 1) normeperidine, 24 to 48 hours, (Szeto et al, 1977; Verbeeck et al, 1980). a) Active metabolites accumulate in patients with ESRD to cause seizures (Bennett et al, 1994a).

b) Normeperidine may accumulate to high concentrations in patients receiving frequent doses of meperidine. Seizures have been attributed to such a process (Szeto et al, 1977; Verbeeck et al, 1980). From Micromedex

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Medication and Drugs
Xanax
Demerol

Is aprotinin off the market?

no no

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Demerol
Percocet and Percodan
Dilaudid

What are cheap narcotic painkillers without insurance?

Methadone

232425
Medication and Drugs
Oxycodone
Painkillers
Demerol
OxyContin

What is stronger Oxycontin or Demerol?

demoral works faster than Oxycontin but the oxy stays in the system longer

181920
Medication and Drugs
DIY Projects
Painkillers
Demerol

How do you give Demerol injections through IV?

You want to give Demerol over about two minutes because it can cause a burning sensation if pushed too fast. Sometimes, if the NS is running at a slow enough rate, you can push the Demerol into a port further away from the patient, allowing the IV fluids to slowly carry the Demerol into your patient.

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Medication and Drugs
Demerol

What type of drug is Demerol?

Demerol is an opioid pain medication. An opioid is sometimes called narcotic. Demerol is used to treat moderate to severe pain and also it may be used for the purposes not indicated in the medication guide. It should not be used by the persons who are all having asthma and breathing problems.

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Medication and Drugs
Chemistry
Painkillers
Demerol

What is the chemical structure compound for Demerol?

c6h5cc5Nch3cooch2ch3

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Drug Interactions
Oxycodone
Demerol

Can you mix oxycodone with promethazine?

Absolutely. Promethazine helps with the nausea that most narcotics cause. I take Promethazine with any narcotic I take no matter what it is.

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Demerol

What is Meperitab generic for?

Demerol

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Medication and Drugs
Hydrocodone
Painkillers
Methadone
Demerol
Vicodin

Can you mix methadone and Vicodin?

You can mix them, you can mix most drugs. Can you mix them safely? No

Methadone, although less appealing, has a more dominant bond to your opioid receptors than Vicodin. Therefor, you usually won't feel the effects of the Vicodin.

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Morphine
Demerol
The Difference Between
Opiates

What is the difference between Demerol and morphine?

Demerol is syntheticaly produced, that is, man made. Morpine is a derivative of opiom and is stronger and more addicting.

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Demerol

Can you shoot up a 50mg Demerol pill?

Yes you can, and the euphoric proprieties surpass that of hydro-morphine. SO HOW DO YOU MIX ITTO SHOOT IT

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Medication and Drugs
Drug Tests
Xanax
Painkillers
Demerol

How long will 1 50 mg Demerol stay in your urine?

3 days .. Its an opioid. They say 2-3 days but I'd give it 3 for sure.

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Health
Medication and Drugs
Drug Side Effects
Drug Addiction
Suboxone
Painkillers
Demerol

Can you have a Demerol shot while taking suboxone?

Yes. My husband had kidney stones and I took him to the emergency room and they gave him several injections in his IV. It didn't make him sick, but it didn't kill the pain either. Finally, they gave him Ativan. BINGO! The nurse said it works everytime.

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Medication and Drugs
Demerol
Cigarettes

Can you smoke demerol?

dont think so but u can shoot it

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Medication and Drugs
Painkillers
Demerol

Cost of Demerol 25 mg?

on the street, about $20 a piece for pills

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Medication and Drugs
Painkillers
Demerol

How do you get demerol?

Get an appointment with a doctor and if the doctor thinks this drug will help you, he/she will prescribe it for you.

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Health
Demerol

How many cc's is equal to 100ml's?

1cc=1mL

100cc=100mL

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Medication and Drugs
Oxycodone
Painkillers
Demerol

Which is stronger Demerol or oxycodone?

oxycodone is way stronger than demerol....youll get messed up off of just 2 pills of oxycodone hahaha take it from me i know my drugs lol

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Medication and Drugs
Painkillers
Demerol

What is the antidote to Demerol?

Demerol and any other opiate overdose can be reversed by Naloxone (Narcan), as it is the preferred opiate blocker for all opioid overdoses.

HOWEVER...

Demerol is different from other opioids in that it also produces a metabolite that is toxic (norpethidine) that is not eliminated by the Narcan. So depending on the amount ingested or if it has been chronically used, eliminating the CNS depressant effects of the Demerol by administering Narcan allows the norpethidine to predominate and can cause even more dangerous convulsions and seizures.

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Health
Medication and Drugs
Painkillers
Demerol

Meperidine Demerol 75mg Im q4h PRN?

Meperidine (demerol ) dosage of 75mg Intermuscularly every 4 hours as needed.

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Demerol

Can you mix Demerol and zofran for IM use?

Yes

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