MEDICATION SHEET

Name & Admin

(Generic &
Brand name;
Dosage, route,
frequency)
meperidine
hydrochloride
Demerol
50 mg IM q6h
PRN

Mechanism of Action (Classification,

physiologic actions)
Opioid analgesic.
Binds with opioid receptors in the CNS,
altering perception of and emotional
response to pain.

Side Effects

CNS: agitation,
incoordination,
clouded sensorium,
dizziness,
euphoria,
lightheadedness,
sedation,
somnolence,
seizures,
hallucinations,
headache,
paradoxical
anxiety, physical
dependence,
syncope, tremor.
CV: bradycardia,
cardiac arrest,
shock,
hypotension,
tachycardia,
palpitations.
GI: biliary tract
spasms,
constipation, dry
mouth, ileus,
nausea, vomiting.
GU: urine
retention.
Musculoskeletal:
muscle twitching.
Respiratory:
respiratory arrest,
respiratory
depression.
Skin: diaphoresis,
pruritus, urticaria.
Other: induration,
local tissue

Nursing Responsibilites &

Patient Teaching
In elderly patients, patients
using meperidine for longer than
48 hours, those with preexisting
renal or CNS disease, and those
taking more than 600 mg/day,
the active metabolite may
accumulate, causing increased
adverse CNS reactions. Avoid
prolonged use.
Alert: Carefully monitor vital
signs, pain level, respiratory
status, and sedation level in all
patients receiving opioids,
especially those receiving I.V.
drugs, even those given
postoperatively.
When giving drug
parenterally, make sure patient
is lying down.
Drug may be used in some
patients who are allergic to
morphine.
Reassess patients level of
pain at least 15 and 30 minutes
after administration.
Because drug toxicity
frequently appears after several
days of treatment, drug isnt
recommended for treatment of
chronic pain.
In neonates exposed to drug
during labor, monitor
respirations. Have resuscitation
equipment and naloxone
available.
Monitor respiratory and CV
status carefully. Dont give if
respirations are below 12

Rationale for use

with this patient
Treatment of severe
pain.

irritation, pain at
injection site,
phlebitis after I.V.
delivery.

breaths/minute, if respiratory
rate or depth is decreased, or if
change in pupils is noted.
If drug is stopped abruptly
after long-term use, monitor
patient for withdrawal
symptoms.
In postoperative patients,
monitor bladder function.
Monitor bowel function.
Patient may need a stimulant
laxative and stool softener.
Look alike-sound alike: Dont
confuse Demerol with Demulen.
Alert: Explain assessment and
monitoring process to patient
and family. Instruct them to
immediately report difficulty
breathing or other signs or
symptoms of an adverse opioidrelated reaction.
Encourage postoperative
patient to turn, cough, deepbreathe, and use an incentive
spirometer to prevent lung
problems.
Caution ambulatory patient
about getting out of bed or
walking. Warn outpatient to
avoid driving and other
potentially hazardous activities
that require mental alertness
until drugs CNS effects are
known.
Advise patient to avoid alcohol
and sleep aids during therapy.
Caution patient that drug isnt
intended for long-term use.