VetSheet

메페리딘

Meperidine

Meperidine hydrochloride

오피오이드 작용제IMSCIVPO개고양이소형 포유류페렛말소돼지양염소

다른 이름: Demerol · Alodan · Centralgine · Dolantina · Dolantine · Dolestine · Dolosal · Pethidine HCl · Isonipecaine · Meperidine hydrochloride · Pethidini hydrochloridum · Pethidinum

VetSheet 수의사 팀 검수업데이트 2026년 4월 5일근거 기반 수의학 참고자료

감사 완료 v13 용량 근거

구조화 용량 계산 근거

Analgesic (extra-label)

5–10 mg/kgIMSC

인증된 수의사 확인 필요

  • q2-3h

NA

규제 약물인증된 수의사 확인 필요formulary프로토콜 2023감사 dose-audit-plumb-v13

용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.

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개요

메페리딘(페티딘으로도 알려짐)은 주로 진통 목적으로 사용되는 합성 ​오피오이드 작용제​입니다.

​임상 요점:​

  • 과거에는 널리 사용되었으나, 작용 시간이 매우 짧고(개와 고양이에서 1~2시간 미만) 특히 정맥 투여 시 ​히스타민 방출​ 및 저혈압을 유발할 가능성이 높아 현대 수의학에서는 사용이 크게 감소했습니다.
  • 대부분의 다른 오피오이드와 달리 메페리딘은 ​항콜린성(미주신경 차단) 및 음성 변력 작용​을 가지고 있어, 순수 뮤(mu) 작용제에서 흔히 볼 수 있는 서맥 대신 빈맥을 유발할 수 있습니다.
  • 효능은 모르핀의 약 1/3에서 1/8 수준이지만, 동일한 진통 효과를 내는 용량에서는 동등한 호흡 억제를 유발합니다.
  • 이 약물은 C-II 통제 물질(마약류)입니다.

작용 기전

Meperidine acts primarily as an agonist at the mu (μ) opioid receptors in the central nervous system (CNS) and peripheral tissues.

  • ​Receptor Binding:​ Binds to G-protein coupled mu receptors → inhibits adenylate cyclase → decreases intracellular cAMP.
  • ​Ion Channel Modulation:​ Promotes opening of potassium channels (causing hyperpolarization) and inhibits voltage-gated calcium channels (decreasing neurotransmitter release).
  • ​Analgesia:​ Inhibits ascending nociceptive pathways and alters the perception of pain.
  • ​Unique Mechanisms:​ Exhibits ​anticholinergic (vagolytic)​ effects and can cause direct mast cell degranulation leading to histamine release.

안전성·주의사항

금기사항

  • Hypersensitivity to narcotic analgesics
  • Patients receiving monamine oxidase inhibitors (MAOIs)
  • Diarrhea caused by a toxic ingestion (until toxin is eliminated)
  • Envenomations from Centruroides scorpion species, Gila monsters, or Mexican beaded lizards
  • Intravenous (IV) administration
  • Animals at risk from histamine release (e.g., skin allergies, asthma, mast cell tumours)

부작용

  • Respiratory depression
  • Histamine release
  • Bronchoconstriction (dogs)
  • CNS depression
  • Nausea and vomiting
  • Decreased intestinal peristalsis
  • Mydriasis (dogs)
  • Salivation (especially cats)
  • Physical dependence (chronic use)
  • Tachycardia with PVCs (horses)
  • Profuse sweating (horses)
  • Hyperpnea (horses)
  • Severe hypotension (if given IV rapidly)
  • Hypotension (especially if given IV)
  • Local urticaria (after IM injection)
  • Dry mouth
  • Pain on IM injection (due to volume)
  • Neonatal sedation (if given to bitches prior to parturition)

주의

​Important Administration Note:​ Many clinicians state meperidine should NOT be administered intravenously. If given IV, it must be given very slowly to avoid severe hypotension and histamine release. It may also be irritating when given SC.

  • ​Extreme Caution:​ Patients with respiratory disease or acute respiratory dysfunction (e.g., pulmonary edema secondary to smoke inhalation).
  • ​Caution:​ Hypothyroidism, severe renal insufficiency, adrenocortical insufficiency (Addison's disease), geriatric or severely debilitated patients.
  • ​Caution:​ Head injuries or increased intracranial pressure, and acute abdominal conditions (e.g., colic) as it may obscure diagnosis.
  • ​Equine Note:​ May potentiate intestinal obstruction secondary to reduced intestinal motility.

약물 상호작용

CNS Depressants (anesthetics, antihistamines, phenothiazines, barbiturates, tranquilizers)

May cause increased CNS or respiratory depression when used with meperidine.

Diuretics

Opiates may decrease efficacy in CHF patients.

Isoniazid

Meperidine may enhance INH adverse effects.

Monamine Oxidase Inhibitors (MAOIs) (e.g., amitraz, selegiline)

Contraindicated. Can cause severe opiate overdose signs; avoid meperidine for at least 14 days after receiving MAOIs.

Skeletal Muscle Relaxants

Meperidine may enhance neuromuscular blockade.

Tricyclic Antidepressants (clomipramine, amitriptyline)

Meperidine may exacerbate the effects of tricyclic antidepressants.

Warfarin

Opiates may potentiate anticoagulant activity.

CNS depressants (anaesthetics, antihistamines, barbiturates, phenothiazines, tranquillizers)Moderate

Increased CNS or respiratory depression

Monoamine oxidase inhibitors (MAOIs)Major

Serious interaction resulting in coma, convulsions, and hyperpyrexia

모니터링

  • Respiratory rate and depth
  • CNS level of depression or excitation
  • Blood pressure (especially with IV use)
  • Analgesic activity
  • Pain score
  • Heart rate
  • Signs of histamine release (urticaria, bronchoconstriction)

약동학

반감기

고양이Analgesic duration is <2 hours, often <1 hour.개Analgesic duration is <2 hours, often <1 hour.

흡수

Generally well absorbed orally, but a marked first-pass effect limits oral effectiveness. Peak analgesic effects occur between 30-60 minutes after IM or SC injection, with IM having a slightly faster onset.

분포

Widely distributed. Enters human breast milk at concentrations slightly higher than serum.

대사

Metabolized primarily in the liver (mostly hydrolysis with some conjugation).

배설

Approximately 5% is excreted unchanged in the urine.

과다투여

Overdosage may produce profound respiratory and/or CNS depression. Other effects can include cardiovascular collapse, hypothermia, and skeletal muscle hypotonia.

  • ​Species Differences:​ Some species (especially cats) may demonstrate CNS excitability (hyperreflexia, tremors) and seizures at doses >20 mg/kg.
  • ​Treatment:​ Naloxone is the agent of choice for respiratory depression. In massive overdoses, naloxone doses may need to be repeated, as its effects can diminish before subtoxic levels of meperidine are attained. Mechanical respiratory support should be considered. Pentobarbital has been suggested for CNS excitement/seizures in cats, but extreme caution is required as barbiturates and narcotics have additive respiratory depressant effects.

제품

제형

  • Injection
  • Tablets
  • Syrup/Oral Solution
  • Injectable: 10-50 mg/ml solutions (50 mg/ml is most commonly used in veterinary practice)

동물용의약품

  • Pethidine 50 mg/ml injection

인용의약품

  • Meperidine HCl Injection: 25 mg/mL, 50 mg/mL, 75 mg/mL, 100 mg/mL
  • Meperidine HCl Tablets: 50 mg, 100 mg
  • Meperidine HCl Syrup/Oral Solution: 50 mg/5 mL
  • Demerol
  • Meperidine injection

규제 현황

European Union✓ 승인됨처방전의약품 · Schedule 2EMA
🐕 Dogs🐈 Cats

POM (Prescription Only Medicine)

United Kingdom✓ 승인됨처방전의약품 · Schedule 2VMD
🐕 Dogs🐈 Cats

POM-V CD SCHEDULE 2

규제 데이터 없음: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU

보관·안정성

Stable at room temperature. Avoid freezing the injectable solution and protect from light during storage. Does not exhibit significant adsorption to PVC IV bags or tubing.

보호자 정보

​중요:​ 메페리딘은 강력한 처방 진통제(오피오이드)로, 일반적으로 수의사의 직접적인 감독 하에 병원 환경에서만 사용됩니다.

  • ​짧은 작용 시간:​ 이 약물은 반려동물에게서 약효가 매우 빨리(종종 1시간 이내에) 사라지므로, 집으로 가져가서 먹이기보다는 주로 시술 중 주사로 투여됩니다.
  • ​부작용:​ 졸음, 메스꺼움 또는 침 흘림을 유발할 수 있습니다. 입으로 투여할 경우 액체나 알약이 입안을 자극할 수 있으며, 특히 고양이에서 심할 수 있습니다.
  • ​안전성:​ 수의사의 엄격한 지시 없이 반려동물에게 사람용 진통제나 남은 메페리딘을 절대 주지 마십시오. 과다 복용 시 생명을 위협하는 호흡 문제를 일으킬 수 있습니다.

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