big push to avoid using Demerol (meperidine)

You'll see a big push to avoid using Demerol (meperidine).

Hospitals are now restricting its use.

Meperidine is NOT the drug of choice for pain...even for acute pancreatitis or gallbladder pain.

Most clinicians were taught to avoid morphine because it increases bile duct pressure and might worsen these conditions.

But this is a "medical myth"...based on anecdotal evidence.

High morphine doses can cause small increases in biliary sphincter pressure...but this isn't proven to aggravate pancreatitis.

And compared to morphine, meperidine has drawbacks.

It only lasts about 3 hours...has a higher risk of dependence...and is more likely to cause seizures, tremors, and mood changes.

Meperidine also interacts with many drugs...SSRIs, dihydroergotamine, triptans, MAOIs, selegiline, isoniazid, etc.

Recommend morphine or hydromorphone instead of meperidine for most severe pain. They offer longer pain relief with fewer risks.

Save meperidine for patients who can't take other opioids...or for special uses (drug-induced rigors, post-anesthesia shivering, etc).

Avoid giving meperidine to patients who are elderly...have impaired kidney function...have seizure disorders...take MAOIs, SSRIs, etc...or need chronic pain relief.

• Other: Inappropriate Meperidine Use