Merperidine (demerol)

INDEX Generic Name merperidine

Trade Name Demerol

NURS 2236 Clinical Form 3: Clinical Medications Worksheet (You will need to made additional copies of these forms) Classification Dose Route Time/Frequency opioid analgesics 10mg initial PCA initially 1-5mg incremental dose recommended lockout interval 6-10 minutes

Peak Onset 5-7 minutes immediate Why is your patient taking this medication?

Duration 2-3 hours

Mechanism of action and indications Moderate to severe pain (alone or with nonopioid agents) Anesthesia adjunct. Analgesic during labor Preoperative sedation

For IV meds, compatability with IV drips and/or solutions

Nursing Implications (what to focus on) Contraindications/warnings/interactions Hypersensitivity, pregnancy lactation. Use Cautiously in: head trauma, increased intracranial pressure, renal, hepatic, or pulmonary disease, hypothyroidism, adrenal insufficiency, alcoholism Common side effects seizures, confusion, sedation, dysphoria, euphoria, floating feeling, hallucinations, headache, unusual dreams, blurred vision diplopia, miosis, respiratory depression, hypotension, bradycardia, constipation, nausea, vomiting, urinary retention, flushing, sweating

Interactions with other patient drugs, OTC, or herbal medicines (ask patient specifically) MAO inhibitors or procarbazine alcohol, antihistamines and sedative/hypnotics, agonist/ antagonist opioid analygesics. St. Johns Wart.

Nursing Process - Assessment (Pre-administration assessment) Vital signs Assess type, location and intensity of pain Pain scale 1-10 Narcan

Lab value alterations caused by medicine

Be sure to teach the patient the following about this medication Instruct patient how and when to ask for pain medication. Advise patient to call for assistance when ambulating. Advise patient to change positions slowly to minimize orthostatic hypotension. Advise ambulatory patients that nausea and vomiting may be decreased by lying down.

Assessment Why would you hold or not give this med? respirations <10/min seizures

Evaluation Check after giving Decrease in severity of pain without a significant alteration in level of consciousness or respiratory status.