A male client is recovering from a small bowel resection. To relieve pain, the physician prescribes meperidine (Demerol), 75 mg I.M. every 4 hours. How soon after administration should meperidine onset of action occur?
A. 5 to 10 minutes
B. 15 to 30 minutes
C. 30 to 60 minutes
D. 2 to 4 hours
Correct Answer: B. 15 to 30 minutes
Meperidine onset of action is 15 to 30 minutes. It peaks between 30 and 60 minutes and has a duration of action of 2 to 4 hours. Meperidine, also known as pethidine, is in the class of phenylpiperidine as a hydrochloride salt synthetic form of the opioid, which is a white crystalline with a melting point of 186°C. This medication has calcium sulfate, dibasic calcium phosphate, starch, stearic acid, and talc as inactive ingredients. Clinicians use meperidine for the treatment of moderate to severe pain.
Option A: Oral form is not recommended for acute pain control. Using Meperidine for pain control should be considered if no other options are available, in which case the duration of medication use should be limited to less than 48 hours, and the total dosage administered should not exceed 600 mg in 24 hours.
Option C: Meperidine has the same mechanism of action as morphine, which is acting as an agonist to the mu-opioid receptor. The anti-shivering effect may involve the stimulation of k-opioid receptors.
Option D: Meperidine also has some local anesthetic effects because of its interactions with sodium ion channels. Also, meperidine has stimulant effects by inhibition of the dopamine transporter (DAT) and norepinephrine transporter (NET).
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