Miller R R, Jick H
J Clin Pharmacol. 1978 Apr;18(4):180-9. doi: 10.1002/j.1552-4604.1978.tb01591.x.
Of 26,294 hospitalized medical patients monitored in a drug surveillance program, 366 (1.4%) received meperidine orally and 3268 (12.4%) received meperidine parenterally during one or more admissions. Neoplastic disease was the most common category of primary diagnosis (43%) among oral recipients; among parenteral recipients cardiovascular and neoplastic diseases (23% each) were most common. Oral meperidine was prescribed almost exclusively (93%) for pain relief, whereas the parenteral drug also had substantial use (41%) as a diagnostic and preoperative adjunct. Oral meperidine was judged by attending physicians to have provided unsatisfactory pain relief in 22% of recipients, while parenteral meperidine was rated unsatisfactory in 11%. The drug was less effective in patients with a primary diagnosis of neoplastic disease than in patients with other primary diagnoses. Minor gastrointestinal disturbances were the most commonly reported adverse reactions among oral meperidine recipients (2.7%); among parenteral recipients central nervous system effects were most common (1.2%). Seven recipients had life-threatening adverse reactions. However, only two of these were judged definitely related to meperidine, and in both instances other drugs were also definitely implicated. Adverse reactions were dose related.
在一项药物监测项目中监测的26294名住院内科患者中，366名（1.4%）在一次或多次住院期间口服了哌替啶，3268名（12.4%）接受了哌替啶注射。肿瘤疾病是口服哌替啶患者中最常见的主要诊断类别（43%）；在注射哌替啶的患者中，心血管疾病和肿瘤疾病（各占23%）最为常见。口服哌替啶几乎完全（93%）用于止痛，而注射用哌替啶也大量（41%）用作诊断和术前辅助用药。主治医生认为22%的口服哌替啶患者止痛效果不满意，而注射哌替啶患者的不满意率为11%。该药物对原发性诊断为肿瘤疾病的患者的疗效低于其他原发性诊断的患者。轻微胃肠道不适是口服哌替啶患者中最常报告的不良反应（2.7%）；在注射哌替啶的患者中，中枢神经系统影响最为常见（1.2%）。7名患者出现危及生命的不良反应。然而，其中只有2例被判定与哌替啶肯定相关，而且在这两例中也肯定涉及其他药物。不良反应与剂量相关。
