A male client with pancreatitis complains of pain. The nurse expects the physician to prescribe meperidine (Demerol) instead of morphine to relieve pain because:
A. Meperidine provides a better, more prolonged analgesic effect.
B. Morphine may cause spasms of Oddi’s sphincter.
C. Meperidine is less addictive than morphine.
D. Morphine may cause hepatic dysfunction.
Correct Answer: B. Morphine may cause spasms of Oddi’s sphincter.
For a client with pancreatitis, the physician will probably avoid prescribing morphine because this drug may trigger spasms of the sphincter of Oddi (a sphincter at the end of the pancreatic duct), causing irritation of the pancreas. Morphine showed an excitatory effect on the sphincter of Oddi, and might be a cause of Oddi’s sphincter dysfunction(SOD). SO may function as a peristaltic pump to actively expel fluid from the sphincter segment into the duodenum.
Option A: Meperidine has a somewhat shorter duration of action than morphine. Morphine is the standard opium-based analgesic with well-known analgesic effects and side effects. Meperidine (pethidine) is another opioid, but the use of meperidine is not very popular in countries such as the USA and Canada, however, it is still used in Iran for pain management in the ED.
Option C: The two drugs are equally addictive. Meperidine appeared to be safer with a lower risk of addiction when compared to other opioids and because of the anticholinergic effects associated with less biliary spasm or renal colic.
Option D: Morphine isn’t associated with hepatic dysfunction. Respiratory depression is among the more serious adverse reactions with opiate use that is especially important to monitor in the postoperative patient population. Other reported side effects include lightheadedness, sedation, and dizziness.
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