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Meperidine &Dilaudid

Pharm (Test 2)

Meperidine was discovered during search for synthetic _________-like drug. atropine
Meperidine causes a(n) (increase or decrease?) in HR. increase
Meperidine causes some large airway (bronchoconstriction or bronchodilation?) bronchodilation
Does meperidine cause myocardial depression? yes, at doses above 2mg/kg
True or False: meperidine is rarely used in the maintenance of anesthesia in adults. True
What causes N/V after meperidine administration? sensitizes the labyrinth apparatus resulting in dizziness and N/V
What is a common dose of meperidine? 0.5-1mg/kg
Meperidine is an opioid agonist at which receptors? mu and kappa
Compare meperidine's potency to morphine. Meperidine is 1/10 as potent as morphine.
Compare meperidine's solubility to morphine. Meperidine is 11X more lipid soluble than morphine.
_____% of meperidine is protein bound. 60%
How is meperidine metabolized? by demethylation in the liver
What is meperidine's metabolite? normeperidine (90%)
How is normeperidine metabolized? excreted by kidneys
Compare normeperidine's activity to meperidine's? normeperidine is 1/2 as active as meperidine
What is normeperidine's half-life in adults? in neonates? 15hrs in adults, >30hrs in neonates
What effect does normeperidine have on the body? CNS stimulant; seizures w/ toxic levels of accumulation (Demerol dose of >5mg/kg; typically repeat doses or infusions) or renal failure
What is a typical meperidine duration? 2-4 hrs
What is an IM dose of meperidine? and duration of IM dose? 100mg IM q4hr; duration=1 hr 24min
What is the most common post-op indication of the use of meperidine? post-op shivering
How dose meperidine decrease post-op shivering? stimulation of kappa receptors or decreased shivering threshold; alpha2 receptor stimulation
Does histamine displacement occur with meperidine administration? yes, but less than morphine
Oral absorption of meperidine is (better or worse?) than morphine/ better
Meperidine has (great or poor?) cough suppression. poor
What can happen when meperidine is given with antidepressant MAOI? serotonin syndrome
What are s/s of serotonin syndrome? HTN, tachycardia, diaphoresis, hyperthermia, confusion, agitation, neuromuscular changes (hyperreflexia), coma, seizures, coagulopathy, metabolic acidosis
True or False: Hydormorphone is a synthetic drug? False: it is a semi-synthetic
Are hydromorphone's metabolities active or inactive? inactive
Compare eqipotent doses of hydromorphone and morphine and fentanyl. 1.5mg of hydromorphone to 10mg of morphine and 100mcg of fentanyl.
What is a typical dose of hydromorphone? 0.2-0.6mg/kg
What is the onset of hydromorphone? 5 min
What is the duration of hydromorphone? 4-5 hrs
What is the elimination 1/2 life of hydromorphone? 2-3 hrs
Respiratory depression with hydromorphone is (more or less?) likely with opioid-naïve patients? more
Compare hydromorphone's euphoria to other opioids. less euphoria
How is hydromorphone metabolized? phase II conjugation via glucuronic acid (similar to morphine)