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Meperidine

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101. The relative efficacy of meperidine for the treatment of acute migraine: a meta-analysis of randomized controlled trials (PubMed)

The relative efficacy of meperidine for the treatment of acute migraine: a meta-analysis of randomized controlled trials Despite guidelines recommending against opioids as first-line treatment for acute migraine, meperidine is the agent used most commonly in North American emergency departments. Clinical trials performed to date have been small and have not arrived at consistent conclusions about the efficacy of meperidine. We performed a systematic review and meta-analysis to determine (...) identified, of which 11 were appropriate and had available data. Four trials involving 254 patients compared meperidine to dihydroergotamine, 4 trials involving 248 patients compared meperidine to an antiemetic, and 3 trials involving 123 patients compared meperidine to ketorolac. Meperidine was less effective than dihydroergotamine at providing headache relief (OR=0.30; 95% confidence interval [CI] 0.09 to 0.97) and trended toward less efficacy than the antiemetics (OR=0.46; 95% CI 0.19 to 1.11

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2009 EvidenceUpdates

102. Synthesis and Structure-Activity Studies of Benzyl Ester Meperidine and Normeperidine Derivatives as Selective Serotonin Transporter Ligands (PubMed)

Synthesis and Structure-Activity Studies of Benzyl Ester Meperidine and Normeperidine Derivatives as Selective Serotonin Transporter Ligands A series of benzyl esters of meperidine and normeperidine were synthesized and evaluated for binding affinity at serotonin, dopamine and norepinephrine transporters. The 4-methoxybenzyl ester 8b and 4-nitrobenzyl ester 8c in the meperidine series and 4-methoxybenzyl ester 14a in the normeperidine series exhibited low nanomolar binding affinities

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2010 Bioorganic & medicinal chemistry

103. Obstetric analgesia: a comparison of patient-controlled meperidine, remifentanil, and fentanyl in labour. (PubMed)

Obstetric analgesia: a comparison of patient-controlled meperidine, remifentanil, and fentanyl in labour. To compare the analgesic efficacy of remifentanil with meperidine and fentanyl in a patient-controlled setting (patient-controlled analgesia, PCA).Parturients (n=159) were randomly assigned to receive remifentanil (n=52), meperidine (n=53), or fentanyl (n=54). Pain scores and an observer sedation scores were assessed hourly. Fetal outcome was evaluated with Apgar score, cord blood gas (...) more parturients receiving meperidine crossed over to epidural analgesia. Overall satisfaction scores were higher with remifentanil, but remifentanil produced more sedation and itching. More periods of desaturation (Sa(o(2)) <95%) were observed during administration of remifentanil and fentanyl. There were no significant differences in fetal outcome between the three groups.The efficacy of meperidine, fentanyl, and remifentanil PCA for labour analgesia varied from mild to moderate. Remifentanil PCA

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2010 British Journal of Anaesthesia

104. Efficacy of tramadol vs meperidine in vasoocclusive sickle cell crisis. (PubMed)

Efficacy of tramadol vs meperidine in vasoocclusive sickle cell crisis. Despite progress in management, patients with sickle cell disease who are experiencing acute painful episode are often incompletely treated. We compared meperidine and tramadol with respect to their effects on the hemodynamics and pain relief in patients with sickle cell disease who were admitted to the emergency department with painful crisis. A total of 68 patients with sickle cell disease were randomly assigned (...) to receive either tramadol 1.5 mg/kg (n = 34) or meperidine 1 mg/kg (n = 34). Hemodynamic parameters were recorded at regular intervals after analgesic infusions. Pain intensity and relief were documented by visual analog and pain relief scale, respectively. Sedation level was defined according to Ramsay sedation scale. Both meperidine and tramadol administration resulted in a significant reduction in systolic and diastolic blood pressure after 2 hours (P < .05). Efficacy in pain relief between

2010 American Journal of Emergency Medicine

105. Meperidine Versus Drotaverine Regarding the Effect on the Duration of the First Stage of Labor in Full Term Primigravidae

Meperidine Versus Drotaverine Regarding the Effect on the Duration of the First Stage of Labor in Full Term Primigravidae Meperidine Versus Drotaverine Regarding the Effect on the Duration of the First Stage of Labor in Full Term Primigravidae - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum (...) number of saved studies (100). Please remove one or more studies before adding more. Meperidine Versus Drotaverine Regarding the Effect on the Duration of the First Stage of Labor in Full Term Primigravidae The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our for details. ClinicalTrials.gov Identifier: NCT01236651 Recruitment Status : Unknown Verified

2010 Clinical Trials

106. Efficacy of Bispectral Index Monitoring for Midazolam and Meperidine Induced Sedation During Endoscopic Submucosal Dissection

Efficacy of Bispectral Index Monitoring for Midazolam and Meperidine Induced Sedation During Endoscopic Submucosal Dissection Efficacy of Bispectral Index Monitoring for Midazolam and Meperidine Induced Sedation During Endoscopic Submucosal Dissection - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached (...) the maximum number of saved studies (100). Please remove one or more studies before adding more. Efficacy of Bispectral Index Monitoring for Midazolam and Meperidine Induced Sedation During Endoscopic Submucosal Dissection The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our for details. ClinicalTrials.gov Identifier: NCT01157598 Recruitment Status

2010 Clinical Trials

107. Managing opioid use disorder in primary care: PEER simplified guideline

creating recommen- dations on their use. 22 Management of comorbid conditions in patients with OUD Management of comorbidities in patients taking OAT can be challenging. Unfortunately, randomized con- trolled evidence in this area is severely lacking. With regard to the management of acute pain in patients taking OAT, 1 RCT reported morphine was superior to meperidine in an emergency setting. 22 This is not always applicable in an ambulatory setting, and nonopioid options were not explored. Similarly

2019 CPG Infobase

108. Management of Cancer Medication-Related Infusion Reactions

, urticaria • 1st generation H1-receptor antagonist (e.g. diphenhydramine 25-50 mg IV) x 1 2,95,96,98-101 • Ranitidine 50 mg IV 95,96,101 or Famotidine 20 mg IV x1 98 • Hydrocortisone 100 mg IV x 1 98-100 Fever • Antipyretic (e.g. acetaminophen 650 mg PO x 1 98-100 ) Rigors/chills † • Meperidine 25-50 mg IV x 1 97,98 Nausea and/or vomiting • Dimenhydrinate 25-50 mg IV x 1 99,100 Hypotension • Normal saline as per hospital policy Wheezing/SOB • Salbutamol 2.5-5 mg nebules inh q 20 min x 3 doses, then q1-4h

2019 Cancer Care Ontario

109. Trastuzumab (Ogivri) - breast cancer or stomach cancer

be used to reduce risk of occurrence of these events. The majority of these events occur during or within 2.5 hours of the start of the first infusion. Should an infusion reaction occur the infusion should be discontinued or the rate of infusion slowed and the patient should be monitored until resolution of all observed symptoms (see section 4.2). These symptoms can be treated with an analgesic/antipyretic such as meperidine or paracetamol, or an antihistamine such as diphenhydramine. The majority

2019 European Medicines Agency - EPARs

111. Peripartum Analgesia and Anesthesia for the Breastfeeding Mother

and neo- natal neurobehavioral organization is also controversial and inconclusive in its long-term effects on breast- feeding outcomes. There may be depressed hand mas- sage and suckling behavior in neonates exposed to neuraxial analgesia, but some of the neonates studied were also exposed to oxytocin and/or meperidine/ pethidine during the course of labor, which were not accounted for in statistical analysis. There were no long-term differences in breastfeeding outcomes or these outcomes were (...) . Remifentanil is potent and has rapid onset and offset, but can be associated with a high incidence of maternal apnea, requiring in- creased monitoring 26 (IIB-III). Remifentanil has also been shown to result in a number of cases of neonatal depression in a recent survey in academic centers across the United States. 27 Evidence on breastfeeding outcomes is lacking. • Longer-acting opioids with active metabolites such as meperidine/pethidine or morphine should be used with caution and administered less than

2019 Academy of Breastfeeding Medicine

112. Promethazine

received either placebo or midazolam or promethazine 5 minutes before appendectomy. All episodes of vomiting and nausea within 24 hours after surgery were 2011 19. Ketorolac versus meperidine-plus- promethazine treatment of migraine headache: evaluations by patients. 7893296 1995 04 27 1995 04 27 2013 11 21 0735-6757 13 2 1995 Mar The American journal of emergency medicine Am J Emerg Med Ketorolac versus meperidine-plus- promethazine treatment of migraine headache: evaluations by patients. 146-50 (...) This study was designed to compare and contrast the speed and efficacy of meperidine (75 mg)/ promethazine (25 mg) intramuscularly to ketorolac (60 mg (...) ketorolac (60 mg) or meperidine (75 mg)/ promethazine (25 mg). Sixty-eight percent of patients given meperidine/ promethazine responded whereas 55% of patients given ketorolac responded. The responder group showed a statistically significant reduction in headache within 30 minutes with both drug regimens. There was no statistically significant

2018 Trip Latest and Greatest

113. Diazepam

). Behavior during local anesthesia, application of rubber dam, cavity preparation, restorative procedures was evaluated, considering the degree of sleep, body movement, crying 2007 12. Intra-articular lidocaine versus intravenous meperidine/ diazepam in anterior shoulder dislocation: a randomised clinical trial. 18434457 2008 04 24 2008 05 19 2013 11 21 1472-0213 25 5 2008 May Emergency medicine journal : EMJ Emerg Med J Intra-articular lidocaine versus intravenous meperidine/ diazepam in anterior (...) shoulder dislocation: a randomised clinical trial. 262-4 10.1136/emj.2007.051060 Anterior shoulder dislocation is one of the most common complaints of patients referred to emergency (...) departments. Intravenous opiates and benzodiazepines are traditionally prescribed in order to relieve the pain in this group of patients; however, complications always pose a problem. To compare the pain relief and complications following intra-articular lidocaine and intravenous meperidine/ diazepam in patients

2018 Trip Latest and Greatest

116. Critical Issues in the Evaluation and Management of Adult Patients Presenting to the Emergency Department With Acute Headache

%) and in the hydromorphone arm by 26 of 64 patients (41%) 398 (difference 19%, 95% CI 2% to 36%; number needed to treat 6, 95% CI 3 to 52). The authors concluded that 399 intravenous hydromorphone is substantially less effective than intravenous prochlorperazine for the treatment of 400 acute migraine in the ED and should not be used as first-line therapy. 401 In a 2008 Class II systematic review, Friedman et al 34 performed a meta-analysis of randomized controlled 402 trials comparing meperidine versus several other (...) regimens (dihydroergotamine [DHE], ketorolac, or an antiemetic) 403 in the treatment of headache. In this study the authors looked at 899 citations and identified 19 trials for inclusion. 404 Within the review’s analysis, 11 studies were determined to have appropriate and available data. Four trials 405 compared meperidine with DHE, 4 compared meperidine with an antiemetic, and 3 compared meperidine with 406 ketorolac. The authors showed that meperidine was not superior to the other regimens

2019 American College of Emergency Physicians

117. Palliative Care for the Patient with Incurable Cancer or Advanced Disease: Part 2: Pain and Symptom Management

transdermal or methadone a morphine b , codeine, meperidine c Compliance and convenience time release formulations (e.g., morphine, hydromorphone, oxycodone) Neuropathic pain oxycodone or methadone d (anecdotal evidence) Opioid naïve low dose morphine, hydromorphone or oxycodone fentanyl transdermal patch (risk of delayed absorption and overdose potential), sufentanil Injection route (e.g., SC) morphine, hydromorphone, second line: methadone by buccal or rectal route e oxycodone (injectable (...) ) is not available in Canada Patient is at extreme risk of respiratory depression Buprenorphine transdermal patch f a Fentanyl is primarily (75%) cleared as inactive metabolites by the kidney and methadone is cleared hepatically. b Morphine is the least preferred in renal failure because of renally cleared active metabolites. c Meperidine (Demerol®) should not be used for the treatment of chronic pain. d If a patient in your practice is started on methadone by a palliative care physician, in order to renew

2017 Clinical Practice Guidelines and Protocols in British Columbia

119. CRACKCast E162 – Opioids

, methadone, and meperidine. Opioids are a major cause for concern today – in overdose they cause respiratory depression and death. In 2010 alone, enough prescription opioids were prescribed to medicate every American adult with 5 mg of hydrocodone every 4 hours for 1 month. Consequently, the United States has seen a widespread rise in prescription opioid abuse, overdoses, and deaths. In 2010, approximately 12 million Americans, or 1 in 20, reported use of opioids without a prescription. Nearly 15,000 (...) overdose or overdose of unknown substance! 1) List 6 commonly abused opioids (Table 156:1) Heroin (semisynthetic) Codeine (in its various forms e.g. Tylenol #3) Fentanyl Hydromorphone Morphine Methadone Oxycodone Meperidine 2) Describe the opioid toxidrome (list opioid effects on Neuro, Resp, Ophtho, CV, GI, Derm) Opioids act on receptors in the central nervous, cardiovascular, pulmonary, and gastrointestinal systems and can also be used therapeutically for their antitussive and antidiarrheal effects

2018 CandiEM

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