哌替啶

各物種劑量

給藥途徑

禁忌症

• 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)

不良反應

• 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)
• Tachycardia
• Bronchoconstriction

藥物相互作用

• 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) · Increased CNS or respiratory depression · moderate
• Monoamine oxidase inhibitors (MAOIs) · Serious interaction resulting in coma, convulsions, and hyperpyrexia · major

監測

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

過量

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.