Pharmacology 2: Therapeutic Uses of Meperidine

Therapeutic Uses of Meperidine

• Used for severe visceral pain, especially myocardial infarction with bradycardia, as it lacks vagal stimulant action, making it a better choice than morphine
• Effective in biliary and renal colic when used alone, due to its atropine-like spasmolytic action
• Used as pre-anesthetic medication, preferred over morphine
• Used in obstetric analgesia, as it doesn't delay labor and doesn't have a spasmogenic effect on the uterus, reducing the risk of asphyxia neonatorum

Meperidine Side Effects

• Causes atropine-like effects, including dry mouth and blurred vision
• High doses or use in renal failure can lead to accumulation of toxic norpethidine, causing adverse effects
• Not recommended for use beyond 48 hours, and contraindicated in renal failure patients

Methadone

• Used for treatment of opioid addicts, for detoxification and maintenance
• Orally active and long-acting, making it a suitable substitute for morphine or heroin in addicts during withdrawal

Buprenorphine

• Used as a sublingual alternative to methadone for treatment of opioid addicts
• Has a long-acting effect and slowly dissociates from receptors, making it a suitable option

Pure Opioid Antagonists

Naloxone

• Administered via IV, with a short-acting effect
• Used for management of acute opioid toxicity
• Repeated doses may be necessary to avoid relapse into coma, as its duration of action is shorter than that of opioids
• Also used to stimulate respiration in opioid-induced respiratory depression in newborns (asphyxia neonatorum)

Naltrexone

• Administered orally, with a long-acting effect
• Used for maintenance therapy in opioid addicts, blocking the euphoric effects of opioids and reducing the desire to take drugs
• Also used to treat opioid abuse, alcohol abuse, and to prevent relapse in chronic alcoholics