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’s 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 is in the class of phenylpiperidine as a hydrochloride salt synthetic form of the opioid. Meperidine is used for the treatment of moderate to severe pain. It has intramuscular, subcutaneous, intravenous injection, syrup, and tablet forms.
Option A: Injection should be into large muscle mass, and it is preferable to subcutaneous injection. 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: For intravenous (IV) injection, inject the dose of 10 mg/ml slowly. The injection should be a consideration only when an opiate antagonist and the administration of oxygen and respiratory monitoring facilities are available. In the 20th century, it was the drug of choice amongst the opioids in the management of acute pain by most physicians and the management of some patients with chronic pain. Meperidine is also being used as an adjunct to preoperative medications to reduce shivering.
Option D: 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.
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