Beckwith M Christina, Fox Erin R, Chandramouli Jane
University Hospitals and Clinics, and College of Pharmacy, University of Utah, Salt Lake City 84132, USA.
J Pain Palliat Care Pharmacother. 2002;16(3):45-59. doi: 10.1080/j354v16n03_05.
Meperidine is FDA-approved for relieving moderate to severe pain and has been widely used since its introduction in the 1930s. However, the drug is no longer considered a first-line analgesic. Many clinicians recommend that meperidine be removed from health-systems or that its use be restricted, due to concerns about adverse reactions, drug interactions, and normeperidine neurotoxicity. In addition, clinical evidence shows that meperidine has no advantage over other opioids for biliary colic or pancreatitis. The formulary status of meperidine has been extensively discussed at University of Utah Hospitals and Clinics. The Pharmacy and Therapeutics Committee has been working with hospital staff to assess the impact of either removing meperidine from the formulary, or limiting its use. The Drug Information Service developed this document to help pharmacists respond to prescribers' questions and to alleviate the prescribers' concerns about these changes. Information is provided comparing meperidine with other opioids, including dosage equivalency, pharmacodynamics, pharmacokinetics, cost, adverse effects, and drug interactions. Where available, alternatives to meperidine are suggested for various indications.
哌替啶已获美国食品药品监督管理局（FDA）批准用于缓解中度至重度疼痛，自20世纪30年代引入以来已被广泛使用。然而，该药物不再被视为一线镇痛药。由于担心不良反应、药物相互作用和去甲哌替啶神经毒性，许多临床医生建议从医疗系统中停用哌替啶或限制其使用。此外，临床证据表明，在治疗胆绞痛或胰腺炎方面，哌替啶相对于其他阿片类药物并无优势。犹他大学医院及诊所已对哌替啶的处方集状态进行了广泛讨论。药学与治疗学委员会一直在与医院工作人员合作，评估从处方集中删除哌替啶或限制其使用的影响。药物信息服务部编写本文件，以帮助药剂师回答开处方者的问题，并减轻开处方者对这些变化的担忧。文中提供了哌替啶与其他阿片类药物的对比信息，包括剂量等效性、药效学、药代动力学、成本、不良反应和药物相互作用。对于各种适应症，如有可用的药物，本文还给出了哌替啶的替代药物建议。
